Tag: pubmed

Arch Environ Contam Toxicol. 2023 Oct 29. doi: 10.1007/s00244-023-01035-9. Online ahead of print.

ABSTRACT

In 2018, the dietary exposure bioaccumulation fish test of the Organization for Economic Co-operation and Development Test Guideline No. 305 was introduced into Japan’s Chemical Substances Control Law. The Japanese government has adopted a single definitive testing criterion for the absence of high bioaccumulation: the growth-corrected kinetic dietary magnification factor (BMF_Kg) must be less than 0.007. The aim of this study was to decrease regulatory restrictions in order to increase newly developed chemical substances and their subsequent approval of their manufacture and import, i.e., the present study was motivated by concerns over the criterion being too restrictive, rather than scientific concerns, such as uncertainty in criterion. We used statistical post-processing to assess the possibility of expanding the criteria for not being highly bioaccumulative. Based on our results, we proposed the criterion that the test substance should be considered not highly bioaccumulative if the following two conditions are met: (1) The ratio of the maximum to the minimum measured 5% lipid-standardized biomagnification factor at the end of the uptake phase (BMF_5%, n = 5) for the test substance and reference substance should be less than 3.0, and (2) For the measured BMF_5% of the test substance (n = 5), the probability that the next (the sixth) BMF_5% is below 0.0334 should exceed 95% based on statistical post-processing. It is worth noting that the BMF_5% values should only be applied for non-ionizable lipid soluble compounds. Application of our suggested approach to Japan implies that the criterion for chemical substances that are not highly bioaccumulative in the dietary exposure bioaccumulation fish test would be increased from 0.007 to 0.0149.

PMID:37898995 | DOI:10.1007/s00244-023-01035-9

J Anesth. 2023 Oct 29. doi: 10.1007/s00540-023-03273-6. Online ahead of print.

ABSTRACT

PURPOSE: There are few reports regarding the association between the neutrophil-lymphocyte ratio (NLR), uric acid, and the development of postoperative delirium (POD) in patients who are undergoing spine surgeries. We investigated the associations between the NLR, uric acid as a natural antioxidant, and POD in elderly patients undergoing degenerative spine surgery.

PATIENTS AND METHODS: This was a single-center, observational, and retrospective study conducted in Japan. We enrolled 410 patients who underwent degenerative spine surgery. POD was diagnosed after the surgeries by psychiatrists, based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). We performed a multivariable logistic regression analysis to clarify whether the NLR and uric acid values were associated with the development of POD in the patients.

RESULTS: 129 of the 410 patients were excluded from the analysis. Of the 281 patients (137 females, 144 males), 32 patients (11.4%) were diagnosed with POD. The multivariable logistic regression analysis revealed that the preoperative uric acid level (adjusted odds ratio [aOR]: 0.67, 95% confidence interval [CI]: 0.49-0.90, p = 0.008) and age (aOR: 1.09, 95% CI: 1.02-1.16, p = 0.008) were significantly associated with POD. The preoperative NLR (aOR: 0.82, 95% CI: 0.60-1.13, p = 0.227) and antihyperuricemic medication (aOR: 0.97, 95% CI: 0.24-3.82, p = 0.959) were not significantly associated with POD.

CONCLUSION: Our results demonstrated that in elderly patients undergoing degenerative spine surgery, the preoperative NLR was not significantly associated with POD, but a lower preoperative uric acid value was an independent risk factor for developing POD. Uric acid could have a neuroprotective impact on POD in patients with degenerative spine diseases.

PMID:37898990 | DOI:10.1007/s00540-023-03273-6

J Med Imaging Radiat Oncol. 2023 Oct 29. doi: 10.1111/1754-9485.13592. Online ahead of print.

ABSTRACT

INTRODUCTION: Malignant pleural mesothelioma is difficult to prognosticate. F18-Fluorodeoxyglucose positron emission tomography (FDG PET) shows promise for response assessment but is confounded by talc pleurodesis. F18-Fluorothymidine (FLT) PET is an alternative tracer specific for proliferation. We compared the prognostic value of FDG and FLT PET and determined the influence of talc pleurodesis on these parameters.

METHODS: Overall, 29 prospectively recruited patients had FLT PET, FDG PET and CT-scans performed prior to and post one chemotherapy cycle; 10 had prior talc pleurodesis. Patients were followed for overall survival. CT response was assessed using mRECIST. Radiomic features were extracted using the MiM software platform. Changes in maximum SUV (SUVmax), mean SUV (SUVmean), FDG total lesion glycolysis (TLG), FLT total lesion proliferation (TLP) and metabolic tumour volume (MTV) after one chemotherapy cycle.

RESULTS: Cox univariate analysis demonstrated FDG PET radiomics were confounded by talc pleurodesis, and that percentage change in FLT MTV was predictive of overall survival. Cox multivariate analysis showed a 10% increase in FLT tumour volume corresponded with 9.5% worsened odds for overall survival (P = 0.028, HR = 1.095, 95% CI [1.010, 1.187]). No other variables were significant on multivariate analysis.

CONCLUSION: This is the first prospective study showing the statistical significance of FLT PET tumour volumes for measuring mesothelioma treatment response. FLT may be better than FDG for monitoring mesothelioma treatment response, which could help optimise mesothelioma treatment regimes.

PMID:37898984 | DOI:10.1111/1754-9485.13592

Int J Health Plann Manage. 2023 Oct 29. doi: 10.1002/hpm.3721. Online ahead of print.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has stretched Bangladesh government’s capability for disaster engagement. As normalcy is interrupted, people’s confidence in the government in ending the crisis needs evaluation, especially considering the past vaccination successes in Bangladesh and growing worldwide vaccine hesitancy amidst the COVID-19 misinfodemic. This study assessed the level of public life disruption due to the pandemic at the micro-level and how much impact it had on people’s trust in the government’s capacity for successful national immunisation.

METHODS: Given the infectious nature of the pandemic, the study conducted an online survey of 2291 respondents, distributed proportionally across sex and income groups. We conducted bivariate analyses and fitted generalised linear models to assess disruption to respondents’ lives, and their trust in the government’s immunisation ability, which were measured using multiple parameters.

RESULTS: Nearly 50% of the respondents reported multifaceted disputations in their daily lives, with 90% suffering financially. Trust in the government was very low at the time of the survey as only 11.3% of respondents had faith that the government could successfully conduct a mass vaccination campaign. Rural residents and non-earning members of families found their lives to be less disrupted. Comparatively higher income families and highly educated individuals had lesser confidence in the government’s inoculation capabilities.

CONCLUSIONS: For the vaccine campaign to be successful, effective risk communication and timely display of data-driven decision-making efforts targeting the groups who are more sceptical of immunisation campaigns could be of significance to the Bangladesh government.

PMID:37898969 | DOI:10.1002/hpm.3721

Int Urol Nephrol. 2023 Oct 29. doi: 10.1007/s11255-023-03843-3. Online ahead of print.

ABSTRACT

OBJECTIVE: This review aimed to assess the utility of urinary N-acetyl-β-D-glucosaminidase (uNAG) as a prognostic biomarker for nephropathy in patients with type 2 diabetes mellitus.

METHODS: The search for relevant studies was conducted across multiple databases, including PubMed (Medline), EMBASE, LILACS, CENTRAL, IBECS, and gray literature. We employed a random effects model to calculate the standardized mean difference and 95% confidence interval. Furthermore, we assessed heterogeneity using Cochrane’s Q test and Higgins’ I2 statistics.

RESULTS: This review included a total of 16 articles involving 1669 patients, with 13 being case-control studies and three being cohorts. The meta-analysis conducted across all studies revealed significant heterogeneity. However, subgroup analysis of four studies indicated that an increase in uNAG among normoalbuminuric patients was associated with the development of macroalbuminuria (DMP = – 1.47; 95% CI = – 1.98 to 0.95; p < 0.00001; I² = 45%). Conversely, it did not demonstrate effectiveness in predicting the development of microalbuminuria (DMP = 0.26; 95% CI = – 0.08 to 0.60; p = 0.13; I² = 17%).

CONCLUSIONS: Elevated uNAG levels in normoalbuminuric patients may indicate an increased risk for the development of macroalbuminuria, but not microalbuminuria. However, the high heterogeneity observed among the studies highlights the necessity for further research to validate these findings.

PMID:37898960 | DOI:10.1007/s11255-023-03843-3

Wiad Lek. 2023;76(9):2103-2111. doi: 10.36740/WLek202309129.

ABSTRACT

OBJECTIVE: The aim: The article examines the peculiarities of the Ukrainian state policy in the field of digitalization, reveals the social challenges caused by this phenom¬enon, and outlines the ways to overcome them.

PATIENTS AND METHODS: Materials and Methods: The data collection was carried out using PubMed, Scopus, Google Scholar databases. Research papers were identified according to the search terms: “digitalization”, “digital transformations”, “Internet”, “digital services”, “smart city”, “smart urbanization”, “inclusion”, “social exclusion”, “community mental health”, “volunteering”, “social partnership”. The authors analyzed international and domestic official strategies, programs, and messages along with statistical data and social surveys conducted by foreign and Ukrainian institutions, public organizations, and analytical centers. The authors used the interdisciplinary approach along with the principles of objectivity, tolerance, and impartiality, and general scientific methods, such as induction, deduction, generalization, etc.

CONCLUSION: Conclusion: The rapid spread of digital technologies is associated with the growth of social cohesion, inclusion, solidarity, and the development of a healthy harmonious society that will provide all the conditions for a decent life for a human being and the comprehensive development of his/her abilities and talents. These hopes are not groundless, because digitalization is accompanied by a number of structural shifts in economics and public administration, which contribute to overcoming subjectivity in making management decisions and increasing the level of “intellectualization” of the environment. In addition, digitalization is becoming a significant driver of the sustainable growth in labor productivity, employment levels, personal and social well-being; and the spread of digital technologies provides an opportunity to overcome various social challenges. As the Ukrainian experience reveals, despite a number of positive shifts, digitalization can also give rise to destructive social trends, among which the digital gaps caused by the uneven access to digital technologies and services occupy a special place. People in the city outskirts, small towns, and especially in the remote rural areas often have extremely limited access to the Internet that significantly reduces their social opportunities. These problems became more acute after the full-scale invasion of the russian federation into Ukraine. The occupation of the part of Ukraine, hostilities, and missile attacks damaged the energy sector blocking telecommunication networks, which led to the social exclusion of a significant part of the population in some Ukrainian regions. The harsh living conditions during the war, the social exclusion as a result of the occupation, as well as the destruction of energy infrastructure and civilian objects fueled the activities of the Ministry of Digital Transformation of Ukraine. The proposed services and transformations provided social opportunities for a part of the population, while remaining unable to overcome social exclusion generated by the digital, social, or other gap. Volunteers and social activists usually help to bridge the gap and maintain mental health of the community, which has been suffering from the horrors of the war for more than a year. Their activities and public position lay the ground for the establishment of social partnership aimed at the harmonious development of every individual and the community as a whole.

PMID:37898951 | DOI:10.36740/WLek202309129

Wiad Lek. 2023;76(9):2047-2053. doi: 10.36740/WLek202309121.

ABSTRACT

OBJECTIVE: The aim is to study the dynamics of prostaglandins and cytokines in the blood and gingival fluid against the background of differential drug correction in patients with generalized periodontitis with different body reactivity.

PATIENTS AND METHODS: Materials and methods: 216 people aged 45 between 55 years with a diagnosis of generalized periodontitis of II, III degree of severity, chronic course were examined. Depending on the state of reactivity of the organism, the patients were divided into three groups: the first one consisted of people with normoreaction; the second group included patients with hyperreaction; the third group was made up of people with hyporeaction. The patients underwent patch surgery after the initial therapy. Initially, on the 1st, 2nd, 4th, 6th and 9th day after the operation, the content of prostaglandins (PG) E, E2, F2alpha and cytokines (IL-1β, IL-6, TNF, IL-4) in the blood and gingival fluid was performed. Patients with impaired body reactivity were treated with the proposed differential drug correction of cytokines and prostaglandins. Statistical processing of the obtained digital data was performed using the computer program Statistica 8.0.

RESULTS: Results: The proposed differential drug correction in patients with generalized periodontitis against the background of hyper- and hyporeactivity of the body brings the content of IL-1β, IL-6, TNF, IL-4 to that of normal body reactivity, which ultimately restores the disturbed balance of pro- and anti-inflammatory cytokines in the blood and gingival fluid. On the 9th day, the content of all proinflammatory cytokines in the main groups was normalized and was commensurate with that of the body’s normal response (p>0.05). Differential drug correction led to normalization of the prostaglandin balance index on day 9 after flap surgery (p>0.05), indicating the establishment of a normal balance of eicosanoids in the blood and approximating the values of pro- and anti-inflammatory fractions of prostaglandins to those of normal body reactivity.

CONCLUSION: Conclusion: Correction of altered parameters in patients with generalized periodontitis accompanied by impaired (hyper- and hypo-) reactivity of the body with bringing them to values that are typical for normoreactivity is considered to be a condition for optimizing mucosal wound healing after surgery and further stabilization of periodontal tissues.

PMID:37898943 | DOI:10.36740/WLek202309121

Wiad Lek. 2023;76(9):1992-1999. doi: 10.36740/WLek202309113.

ABSTRACT

OBJECTIVE: The aim: This study was conducted to compare the results of spider vein: sclerotherapy or radiofrequency thermocoagulation.

PATIENTS AND METHODS: Materials and methods: The study included 52 patients with spider veins, who were randomized into two treatment groups: sclerotherapy or radiofrequency thermocoagulation. Treatment outcomes were assessed using: a self-assessed questionnaire, CIVIQ 20 questionnaire, computer evaluation of images, registration relapses complications, negative manifestations, and intensity of the pain syndrome.

RESULTS: Results: Both methods showed a statistically significant difference in the quality of life indicators before and one month after treatment (p<0.001 for both groups). Radiofrequency thermocoagulation showed a greater impact on the patient’s quality of life (p = 0.003). The average length of spider veins in the treatment area decreased the most with radiofrequency thermocoagulation (by 92.1%), slightly less after sclerotherapy (by 73.4%) (p < 0,01).

CONCLUSION: Conclusions: Both treatments have shown good results for spider veins and were reasonably safe with few negative manifestations. Radiofrequency coagulation better eliminates small veins, less than 0.3 mm.

PMID:37898935 | DOI:10.36740/WLek202309113

Wiad Lek. 2023;76(9):1978-1983. doi: 10.36740/WLek202309111.

ABSTRACT

OBJECTIVE: The aim: To identify the main groups of expert defects that arise during the forensic assessment of changes detected during the examination of persons who died from a traumatic brain injury (TBI).

PATIENTS AND METHODS: Materials and methods: A total of 102 repeated commission forensic medical examinations with changed conclusions in corpses with TBI were analyzed. Data processing and analysis were conducted using statistical methods.

RESULTS: Results: The examined forensic medical assessments of TBI with changed conclusions in corpses were categorized into the following groups: defects in estab¬lishing the diagnosis of TBI – 17.65±7.4%; defects in establishing the mechanism of TBI – 35.3±9.3%; defects in establishing the duration of TBI – 39.22±9.5%: sober – 20±12.4%; with alcohol intoxication – 80±12.4%. A combination of defects was found in 7.83±5.2% of cases. Defects that directly affected the experts’ incorrect establishment of the diagnosis, mechanism, and duration of TBI were also identified.

CONCLUSION: Conclusions: The largest number of changed conclusions during the forensic medical examination of corpses in cases of TBI was due to the wrongly established duration of the trauma, accounting for 39.2±9.5%, with the vast majority of cases (80±12.4%) observed against the background of alcohol intoxication. The mechanism of trauma accounted for 35.3±9.3% of the changed conclusions. The main defects were incomplete collection of material for histological examination (90.2±5.8%) and incorrect interpretation of the results of histological examination (76.48±8.2%), along with the violation of the method of sectional examination (68.6±9.0%). Different groups of expert defects predominated in the cases with an incorrectly established diagnosis of TBI, duration of trauma, and mechanism.

PMID:37898933 | DOI:10.36740/WLek202309111

Wiad Lek. 2023;76(9):1930-1935. doi: 10.36740/WLek202309105.

ABSTRACT

OBJECTIVE: The aim: To determine the peculiarities of the antioxidant-prooxidant balance in the kidney of rats of different ages under conditions of experimental cranioskeletal trauma (CST).

PATIENTS AND METHODS: Materials and methods: The experiments involved 147 male white Wistar rats of different age groups. The first experimental group included immature animals aged 100-120 days. The second group included sexually mature animals aged 6-8 months. The third group included old animals aged 19-23 months. In all experimental groups, CST was modelled under thiopental-sodium anaesthesia. The control groups of rats was only injected with thiopental-sodium anaesthesia. The animals were withdrawn from the experiments under anaesthesia after 1, 3, 7, 14, 21 and 28 days by total bleeding from the heart. The content of reagents to thiobarbituric acid and catalase activity was determined in a 10 % kidney homogenate extract, and the antioxidant-prooxidant index (API) was calculated from the ratio of these two parameters.

RESULTS: Results: As a result of the application of CST in rats of different age groups, a decrease in the value of renal API was observed with a maximum in immature rats – after 7 days, in mature and old rats – after 14 days. By day 28, the index increased in all experimental groups, but did not reach the control level. The degree of decrease in renal API in old rats under the influence of CCT was significantly higher than in other experimental groups. In immature rats, the impairment of renal API after the application of CST was less, indicating higher reserve capacity of the renal antioxidant defence system in this age group of rats.

CONCLUSION: Conclusions: Simulation of CST in rats of different age groups is accompanied by a decrease in the value of API, which by day 28 does not reach the control level in any of the experimental groups. The degree of decrease in renal API value statistically significantly increases with increasing age of rats at all times of the post-traumatic period.

PMID:37898927 | DOI:10.36740/WLek202309105