Tag: pubmed

Fam Process. 2023 Aug 27. doi: 10.1111/famp.12930. Online ahead of print.

ABSTRACT

Community-based family-focused interventions can offer support to families of children with chronic health conditions. This review aimed to evaluate the effectiveness of community-based family-focused interventions in improving family functioning, disease knowledge, and child health outcomes among families of children with chronic health conditions. Eight electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, Scopus, Web of Science, and ProQuest Dissertations & Theses Global) and one trial registry (ClinicalTrials.gov) were searched from their dates of inception to October 2022. Meta-analysis was performed under the random-effect model when appropriate otherwise, findings were narratively synthesized. I² statistics and Cochran’s Q chi-squared test were used to determine heterogeneity. Quality appraisal was conducted by the Cochrane risk of bias tool and the Grades of Recommendation, Assessment, Development, and Evaluation approach at the study and outcome level, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guided this review. Eight studies were included in this review. Community-based family-focused interventions were viable methods that could support families of children with chronic health conditions. Family-focused interventions that incorporate guided role-playing exercises for parents and children, psychoeducational components, and elements from relationship-focused interventions could support families more effectively. However, current findings are mostly limited to interventions conducted in patients’ homes, and the long-term effect of these interventions cannot be determined. Overall, community-based family-focused interventions have the potential to offer valuable support to families of children with chronic health conditions, and future research could seek to improve the effectiveness of these interventions.

PMID:37634898 | DOI:10.1111/famp.12930

J Korean Neurosurg Soc. 2023 Aug 25. doi: 10.3340/jkns.2023.0157. Online ahead of print.

ABSTRACT

OBJECTIVE: Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia (DCI) caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic subarachnoid hemorrhage (aSAH) and evaluate the predictive value of various indices, including systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR), in predicting clinical vasospasm.

METHODS: A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted XXXXXXXXXXX hospital with a confirmed diagnosis of aneurysmal subarachnoid hemorrhage (aSAH) between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients’ condition. The Student’s t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve (AUC), cut-off values, sensitivity, and specificity. A significance level of p < 0.05 was considered statistically significant.

RESULTS: The study included 96 patients divided into two groups: NVS (non-vasospasm) and VS (vasospasm). Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on seven days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided.

CONCLUSION: Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aneurysmal subarachnoid hemorrhage (aSAH), and further studies with larger patient groups are needed to gain more insights.

PMID:37634893 | DOI:10.3340/jkns.2023.0157

Neuroimage. 2023 Aug 25:120346. doi: 10.1016/j.neuroimage.2023.120346. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is one of the most common neurodegenerative diseases. However, the AD mechanism has not yet been fully elucidated to date, hindering the development of effective therapies. In our work, we perform a brain imaging genomics study to link genetics, single-cell gene expression data, tissue-specific gene expression data, brain imaging-derived volumetric endophenotypes, and AD diagnosis to discover potential underlying neurobiological pathways for AD. To do so, we perform brain-wide genome-wide colocalization analyses to integrate multidimensional imaging genomic biobank data. Specifically, we use (1) the individual-level imputed genotyping data and magnetic resonance imaging (MRI) data from the UK Biobank, (2) the summary statistics of the genome-wide association study (GWAS) from multiple European ancestry cohorts, and (3) the tissue-specific cis-expression quantitative trait loci (cis-eQTL) summary statistics from the GTEx project. We apply a Bayes factor colocalization framework and mediation analysis to these multi-modal imaging genomic data. As a result, we derive the brain regional level GWAS summary statistics for 145 brain regions with 482,831 single nucleotide polymorphisms (SNPs) followed by posthoc functional annotations. Our analysis yields the discovery of a potential AD causal pathway from a systems biology perspective: the SNP chr10:124165615:G>A (rs6585827) mutation upregulates the expression of BTBD16 gene in oligodendrocytes, a specialized glial cells, in the brain cortex, leading to a reduced risk of volumetric loss in the entorhinal cortex, resulting in the protective effect on AD. We substantiate our findings with multiple evidence from existing imaging, genetic and genomic studies in AD literature. Our study connects genetics, molecular and cellular signatures, regional brain morphologic endophenotypes, and AD diagnosis, providing new insights into the mechanistic understanding of the disease. Our findings can provide valuable guidance for subsequent therapeutic target identification and drug discovery in AD.

PMID:37634885 | DOI:10.1016/j.neuroimage.2023.120346

J Arthroplasty. 2023 Aug 25:S0883-5403(23)00865-3. doi: 10.1016/j.arth.2023.08.055. Online ahead of print.

ABSTRACT

BACKGROUND: The use of antibiotic-impregnated cement during two-stage revision arthroplasty for periprosthetic joint infection poses a risk of renal complications following spacer insertion. This systematic review aimed to investigate the rate of acute kidney injury (AKI) following antibiotic-loaded spacer insertion and to identify risk factors associated with this complication.

METHODS: A systematic review was performed using PubMed, Cochrane Central, and Scopus databases. All clinical studies that documented renal complications following antibiotic-loaded spacer insertion for periprosthetic knee (TKA) or hip (THA) infection were included. Articles that combined THA and TKA outcomes were also included and labeled ‘THA+TKA.’ Descriptive statistics were analyzed when data were available.

RESULTS: There were 24 studies (9 THA, 7 TKA, 8 THA+TKA) included. Mean incidences of spacer-related AKI across THA, TKA, and THA+TKA cohorts were 4.2 (range, 0 to 10%), 14 (range, 0 to 19%), and 27% (range, 0 to 35%), respectively. The most common patient-related risk factors for AKI were underlying CKD or high baseline creatinine, low preoperative hemoglobin, and blood transfusion requirement. Spacer-related risk factors included high antibiotic dosage (>3.6 g/cement batch) and antibiotic type. While most recovered without complication, select patients required hemodialysis for acute management (2 THA, 18 THA+TKA) and/or developed chronic kidney disease (CKD) (8 TKA, 8 THA).

CONCLUSION: The rate of AKI following spacer insertion was high and likely under-reported in the literature. Surgeons should be cognizant of this devastating complication and should closely monitor at-risk patients for AKI following antibiotic-loaded spacer insertion.

PMID:37634877 | DOI:10.1016/j.arth.2023.08.055

J Pharm Sci. 2023 Aug 25:S0022-3549(23)00337-4. doi: 10.1016/j.xphs.2023.08.018. Online ahead of print.

ABSTRACT

In-vitro models are available in the literature for predicting the volume of distribution at steady-state (Vd_ss) of drugs. The mechanistic model refers to the tissue composition-based model (TCM), which includes important factors that govern Vd_ss such as drug physiochemistry and physiological data. The recognized TCM published by Rodgers and Rowland (TCM-RR) and a subsequent adjustment made by Simulations Plus Inc. (TCM-SP) have been shown to be generally less accurate with neutral compared to ionized drugs. Therefore, improving these models for neutral drugs becomes necessary. The objective of this study was to propose a new TCM for improving the prediction of Vd_ss for neutral drugs. The new TCM included two modifications of the published models (i) accentuate the effect of the blood-to-plasma ratio (BPR) that should cover permeated molecules across the biomembranes, which is lacking in these models for neutral compounds, and (ii) use a different approach to estimate the binding in tissues. The new TCM was validated with a large dataset of 202 commercial and proprietary compounds including preclinical and clinical data. All scenario datasets were predicted more accurately with the TCM-New, whereas all statistical parameters indicate that the TCM-New showed significant improvements in terms of accuracy over the TCM-RR and TCM-SP. Predictions of Vd_ss were frequently more accurate for the TCM-new with 83% within twofold error versus only 50% for the TCM-RR. Overall, the new TCM incorporating BPR significantly improved the Vd_ss predictions in animals and humans for neutral drugs, and, hence, has the potential to better support the drug discovery and facilitate the first-in-human predictions.

PMID:37634869 | DOI:10.1016/j.xphs.2023.08.018

Adv Nutr. 2023 Aug 25:S2161-8313(23)01358-3. doi: 10.1016/j.advnut.2023.08.009. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin A deficiency (VAD) increases risk for morbidity and mortality. Food-based approaches offer one strategy to improve vitamin A status.

OBJECTIVE: This systematic review assessed evidence of the effects of food-based approaches on the vitamin A status of women and children under five years.

METHODS: VAD was defined as clinical ocular symptoms, such as loss of vision, and/or retinol plasma or serum concentration <0.70 μmol/L. Searches on food-based approaches to improve vitamin A status were conducted for the period 2011-2022 on PubMed, CINHAL, Web of Science, and Google Scholar using PRISMA guidelines. English language publications were included. Case studies, unpublished dissertations, and non-peer-reviewed studies were excluded.

RESULTS: This review comprises 24 of 27,322 identified studies; 23 included studies focused on provitamin A carotenoids. There were 17, 214 participants across the 24 studies with sample sizes ranging from 8 to 3571 individuals. Intervention studies spanned from three weeks to two years. Fifteen (63%) studies were randomized control trials, seven were cross-sectional, and two were longitudinal studies. Most studies (N = 21) used biochemical measurements, e.g. serum retinol, to assess vitamin A status; other studies used clinical symptoms (e.g. xerophtalmia) or dietary intake. Thirteen (54%) studies reported a statistically significant effect of food-based interventions (N = 8) or an association of diet (N= 5) on vitamin A status.

CONCLUSIONS: This systematic review indicated that some food-based interventions improved vitamin A status, thus offering a safe and effective delivery mechanism for vitamin A. There appeared to be significant association between vitamin A status and consumption of foods with high concentrations of preformed vitamin A and provitamin A carotenoids. Differences across studies in regard to the period of evaluation, food approaches used, and statistical power may explain the lack of effectiveness of food-based approaches on vitamin A status in some studies.

PMID:37634852 | DOI:10.1016/j.advnut.2023.08.009

J Vasc Interv Radiol. 2023 Aug 25:S1051-0443(23)00635-8. doi: 10.1016/j.jvir.2023.08.024. Online ahead of print.

ABSTRACT

PURPOSE: To compare the mechanistic effects and hypertrophy outcomes using two different PVE regimens in normal and cirrhotic livers in a large animal model.

METHODS AND MATERIALS: The Institutional Animal Care and Use Committee (IACUC) approved all conducted experiments. Fourteen female Yorkshire pigs were separated into a cirrhotic (CG, n=7) and non-cirrhotic group (NCG, n=7); further subgrouped into using microspheres and coils (MC, n=3) or n-butyl-cyanoacrylate (NBCA, n=3) and their corresponding controls (each n=1). A 3:1 ethiodized-oil and ethanol-mixture was administered intraarterially in the CG to induce cirrhosis four-weeks before PVE. Animals received baseline-CT, PVE including pre- and post-PVE pressure-measurements and CT-imaging two and four-weeks post-PVE. Immunofluorescence staining’s for CD3, CD16, Ki-67 and Caspase-3 were conducted to assess immune-cell infiltration, hepatocyte-proliferation and apoptosis. Statistical significance was tested using Student’s t-test.

RESULTS: Four-weeks post-PVE, the FLR% increased by 18.82% (SD:3.55%) vs. 10.93% (SD:0.95% (p<0.01) in the NCG vs. CG. Control baseline sFLR% was 41.59% vs. 43.57%. Seperated by the embolic-agents the standardized FLR% (sFLR%) two-weeks post-PVE was 58.43% (SD:3.66%) and 52.24% (SD:0.88%) (p<0.01) for MC in the NCG vs. CG and 46.02% (SD:2.24%) and 47.24% (SD:0.40%) for NBCA, respectively. sFLR% four-weeks post-PVE was 60.48% (SD:3.88%) and 54.85% (SD:0.83%) (p<0.01), and 60.35% (SD:3.45%) and 54.15% (SD:0.95%) (p<0.01), respectively. Ki-67 signal intensity was increased in the embolized lobe both in the CG and NCG (p<0.01).

CONCLUSIONS: This pre-clinical study demonstratess that MC could be the preferred embolic of choice compared to NBCA when a substantial and rapid FLR increase is needed for resection, both in cirrhotic and non-cirrhotic liver.

PMID:37634850 | DOI:10.1016/j.jvir.2023.08.024

J Affect Disord. 2023 Aug 25:S0165-0327(23)01099-6. doi: 10.1016/j.jad.2023.08.120. Online ahead of print.

ABSTRACT

BACKGROUND: Serum insulin levels and insulin sensitivity can impact mental disorders. This study investigates the association of the insulinemic potential of diet calculated using the empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH) with psychological disorders, including depression, anxiety, and stress.

METHODS: This cross-sectional study was undertaken on 5405 individuals, aged 20-70, from the Yazd Health Study (YaHS). The food frequency questionnaire (FFQ) was used to collect dietary intakes. EDIR and EDIH were calculated from the FFQ data. Psychological disorders were assessed by an Iranian-validated version of the depression, anxiety, and stress scale questionnaire 21 (DASS 21). Multivariable logistic regression analysis was performed and odds ratio (OR) and 95 % confidence interval (CI) were reported.

RESULTS: The mean ± SD of EDIR and EDIH were 0.32 ± 0.17 and 0.11 ± 0.08 in the total population, respectively. In the final adjusted model, participants in the highest versus the lowest quartile of EDIR had statistically higher odds of depression (OR: 1.28; 95 % CI: 1.01-1.62, P-trend = 0.032). However, no statistically significant association was observed between the EDIH score and depression. Also, EDIR and EDIH scores were not significantly associated with the odds of anxiety and stress.

LIMITATIONS: The cross-sectional design of the study prevented the inference of causality.

CONCLUSIONS: Higher adherence to EDIR was positively associated with depression, but there was no significant association between EDIH and depression. EDIR and EDIH were also not significantly related to anxiety or stress.

PMID:37634820 | DOI:10.1016/j.jad.2023.08.120

J Affect Disord. 2023 Aug 25:S0165-0327(23)01101-1. doi: 10.1016/j.jad.2023.08.121. Online ahead of print.

ABSTRACT

BACKGROUND: Osteomyelitis and major depressive disorder (MDD) are significant health concerns with potential interconnections. However, the underlying mechanisms linking these conditions remain unknown. This study aimed to investigate the potential mediating role of non-steroidal anti-inflammatory drug (NSAID) medication in the association between MDD and the risk of osteomyelitis.

METHODS: We utilized summary data from large-scale genome-wide association studies (GWAS) to perform Mendelian randomization (MR) mediation analysis. Instrumental variables were selected based on genome-wide significance, and instrumental strength was assessed using F-statistics. Univariable and multivariable MR analyses were conducted to estimate causal effects and proportions mediated by NSAID medication.

RESULTS: The univariable MR analysis revealed significant associations between MDD and osteomyelitis (odds ratio [OR] = 1.44, 95 % confidence interval [CI]: 1.18-1.874) and between MDD and NSAID medication (OR = 1.36, 95 % CI 1.24-1.49). In the multivariable MR analysis, the direct effect of MDD on osteomyelitis was OR 1.35 (95 % CI: 1.09, 1.67) after adjusting for NSAID medication. The proportion of mediation by NSAID medication was 23 % (95 % CI: 0.05 %, 38.6 %).

CONCLUSION: This MR study provides evidence for a genetically predicted causal association between MDD, NSAID medication, and osteomyelitis. The findings emphasize the need for a comprehensive approach in managing individuals with comorbid depression and osteomyelitis, considering the potential risks and benefits of NSAID medication. Future research should address limitations and explore additional mediators and confounding factors to enhance understanding of this complex relationship.

PMID:37634817 | DOI:10.1016/j.jad.2023.08.121

J Am Coll Radiol. 2023 Aug 25:S1546-1440(23)00628-2. doi: 10.1016/j.jacr.2023.02.037. Online ahead of print.

ABSTRACT

OBJECTIVE: With social media becoming a vibrant hub for the radiology community, highlighting expert leaders and trustful conduits of information in the virtual field is proving crucial. This study aimed to identify and describe the most prominent and influential figures and organizational accounts to follow in radiology.

METHODS: Influence scores for the topic “Radiology” on Twitter were computed using Right Relevance machine learning service. Top influencers were classified according to gender, geography, physician degree, areas of influence, sub-specialization, influence score, title, affiliated institution, dual degree, medical school origin, content type, and research activity. Statistical analysis was performed assessing variable correlations.

RESULTS: In the top quartile of influential figures, 87% were physicians, 60% males, and 93% located in the United States. Prevalent backgrounds included: neuroradiology (21%), abdominal imaging (12%), and artificial intelligence (11%). Of the top 100 figures, 81% were US graduates, 97% holding medical degrees, and 28% with dual degrees. 58% provided educational content. A majority held leadership positions (58%) and academic professorship titles (70%). Median h-index, publication, and citation numbers were 14, 49, and 881, respectively. No significant correlation was noted between influence score and academic rank or research output.

DISCUSSION: Virtual presence is becoming integral to our healthcare professions and academic spheres, unfolding great potential for enhancing the sense of belonging, advocacy, recruitment, and fostering new relationships. Having a core of influential leaders and organizations to follow can serve as a resource for the community members and aspiring students building a positive connected basis for radiology’s thriving future.

PMID:37634801 | DOI:10.1016/j.jacr.2023.02.037