Tag: pubmed

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7541-7549. doi: 10.26355/eurrev_202210_30025.

ABSTRACT

OBJECTIVE: The aim of the current study was to describe the alternation pattern of cerebral and ocular blood flow velocities (BFVs) in symptomatic patients with unilateral carotid stenosis after carotid endarterectomy.

PATIENTS AND METHODS: 20 symptomatic patients underwent carotid endarterectomy for ≥ 50% unilateral carotid stenosis. Cerebral and ocular hemodynamics were evaluated by Transcranial Doppler (TCD) and Color Doppler imaging (CDI), respectively, first preoperatively, then during the following several days after carotid endarterectomy before discharge, and finally two to sixteen months later.

RESULTS: Statistically significant improvements in the BFVs were recorded in the ipsilateral anterior cerebral artery (ACA), middle cerebral artery (MCV) and short posterior ciliary artery (SPCA) during the following several days after carotid endarterectomy. Preoperative retrograde flows of the ipsilateral ophthalmic artery (OA) in two patients returned to anterograde direction immediately following carotid endarterectomy. At the follow-up of two to sixteen months, the BFVs of the ipsilateral ACA, MCA and SPCA tended to decline and were no longer statistically significant from the preoperative values.

CONCLUSIONS: Carotid endarterectomy significantly increased the flow velocities of ipsilateral cerebral anterior circulation and OA branching artery in patients with unilateral carotid stenosis early after surgery. At the long-term follow-up, the flow velocities in the ipsilateral hemisphere had the tendency to reduce and approach the preoperative level.

PMID:36314325 | DOI:10.26355/eurrev_202210_30025

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7514-7521. doi: 10.26355/eurrev_202210_30022.

ABSTRACT

OBJECTIVE: Acute pancreatitis (AP) is one of the diseases that surgical clinics deal with the most. While mortality rates are approximately 1% in all cases, this rate may increase to 15% in pancreatic necrosis cases. Therefore, early diagnosis and treatment are very important in necrotizing pancreatitis. Our aim in this study is to present the guiding effectiveness of procalcitonin and immature granulocyte ratios (IG%) in planning the early diagnosis and treatment of acute necrotizing pancreatitis.

PATIENTS AND METHODS: 582 patients hospitalized in our clinic with the diagnosis of acute pancreatitis were included in this study. All patients were divided into two groups as acute edematous pancreatitis (AEP) and acute necrotizing pancreatitis (ANP) according to tomography results. White blood cell (WBC) count, procalcitonin, IG%, C-reactive protein (CRP), amylase and lipase, albumin, CRP/albumin levels were recorded. The differences between the two groups were analyzed statistically.

RESULTS: According to the results of contrast-enhanced abdominal tomography (CECT), 525 patients were diagnosed with AEP and 57 with ANP. WBC, CRP, procalcitonin, IG and CRP/albumin were found to be significantly higher in ANP patients when compared to AEP (p<0.0001). According to the ROC analysis result, procalcitonin (AUROC: 0.999), IG% (AUROC: 0.995), WBC count (AUROC: 0.841), CRP (AUROC: 0.947), albumin (AUROC: 0.862), and CRP/albumin (AUROC: 0.946) ratio were markers that could be used for early prediction of ANP.

CONCLUSIONS: Early diagnosis of ANP can reduce morbidity and mortality. Procalcitonin and IG% levels can be easily accessible and effective markers in the early diagnosis of ANP and in the planning of treatment.

PMID:36314322 | DOI:10.26355/eurrev_202210_30022

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7454-7460. doi: 10.26355/eurrev_202210_30014.

ABSTRACT

OBJECTIVE: This study used the Sniffin’ Sticks test battery to evaluate olfactory function in employees of a bakery exposed to flour dust.

SUBJECTS AND METHODS: The study enrolled 43 individuals with exposure (i.e., to flour) plus 41 healthy volunteers as controls. Olfactory function was assessed in these subjects through the use of the Sniffin’ Sticks test battery. The overall score was calculated by adding up the scores for each of the 12 separate odors. A score of 6 or less was deemed anosmia, from 7 to 10 hyposmia, and a score of 11 or 12 was taken to indicate no impairment of olfaction.

RESULTS: There was a statistically significant difference between the scores obtained in the exposure group (10.09±2.29) and the control group (10.73±2.07), the exposure group having a lower score (p<0.05). Within the exposure group, men and women did not score differently (p>0.05). Furthermore, in this group, the overall score did not correlate significantly with age, sex, length of employment, or use of tobacco or alcohol use (p>0.05). Using the scheme employed in this study, 9.3% of the exposed workers were anosmic, compared to 9.8% in the controls, whereas 34.9% of baker workers were hyposmic, compared to just 14.6% of the controls. Thus, our study shows that impairment of the ability to smell was present in 44.2% of individuals exposed occupationally to flour dust.

CONCLUSIONS: This study reveals that being exposed to flour dust reduces the ability to smell normally. In order to minimize the impact of being exposed, workplaces should ensure adequate ventilation and provide workers with protective facemasks.

PMID:36314315 | DOI:10.26355/eurrev_202210_30014

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7344-7348. doi: 10.26355/eurrev_202210_30003.

ABSTRACT

OBJECTIVE: An interaction between hereditary and environmental variables is thought to be the cause of keratoconus, a progressive ectatic corneal condition. The identification of risk factors is necessary since they are currently the subject of intense debate and are crucial to the management and prevention of the disease. The objective of this study is to gain a better understanding of the risk factors associated with the onset and progression of keratoconus. It would be valuable for both eye care professionals and patients in Saudi Arabia.

PATIENTS AND METHODS: Patients seeking eye care at Qassim University eye clinic were included in this study. Participants were divided into: cases (with keratoconus) and control (without keratoconus but with other ocular problems). Keratoconus diagnoses of the participants were made by the attending optometrists or ophthalmologists. Multivariate logistic analyses were performed to identify the risk factors for keratoconus. Moreover, by performing logistic regression and CART analysis, supervised learning algorithms were developed to predict the likelihood of keratoconus based on the risk factors.

RESULTS: There were 75 keratoconus patients and 75 control. The CART model to predict the chances of keratoconus occurrence has an accuracy of 73%. Our prediction model can be a baseline model for future risk factor analysis studies that will be done in the Middle Eastern region. The models can be better trained by refining the risk factor quality and also by increasing the keratoconus population in the study. Including clinical parameters in the prediction models would result in complex as well as models with better prediction accuracy.

CONCLUSIONS: Clinical ocular parameters including the corneal topographic variables have to be obtained to better correlate the risk factors with specific changes or the subtypes of the keratoconus. Complex diseases like keratoconus require machine learning models apart from statistical analysis for association and causation. Machine learning models would not only predict the disease but also provide insight into how the risk factors interact with each other.

PMID:36314304 | DOI:10.26355/eurrev_202210_30003

Diabetes Obes Metab. 2022 Oct 31. doi: 10.1111/dom.14911. Online ahead of print.

ABSTRACT

AIMS: Co-management of weight and glycemia is critical yet challenging in type 1 diabetes (T1D). We evaluated the effect of a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction on weight and glycemia in young adults with T1D and overweight or obesity.

MATERIALS AND METHODS: We implemented a nine-month Sequential, Multiple Assignment, Randomized Trial pilot among adults aged 19-30 years with T1D for ≥1 year and BMI 27-39.9 kg/m² . Re-randomization occurred at 3- and 6-months if the assigned diet was not acceptable or not effective. We report results from the initial three-month diet period and rerandomization statistics prior to shutdowns due to COVID-19 for primary (weight, hemoglobin A1c [HbA1c], percent of time below range [%TBR] <70 mg/dL) and secondary outcomes (body fat percentage [BFP], percent of time in range [70-180 mg/dL], and %TBR <54 mg/dL). Models adjusted for design, demographic, and clinical covariates tested changes in outcomes and diet differences.

RESULTS: Adjusted weight and HbA1c (n=38) changed by -2.7 kg (95%CI -3.8, -1.5, p<0.0001) and -0.91 percentage points (95%CI -1.5, -0.30, p=0.005), respectively, while adjusted BFP remained stable, on average (p=0.21). Hypoglycemia indices remained unchanged, on average, following adjustment (n=28, p>0.05). Variability in all outcomes, including weight change, was considerable (57.9% were re-randomized primarily due to loss of <2% body weight). No outcomes varied by diet.

CONCLUSIONS: Three months of a diet, irrespective of macronutrient distribution or caloric restriction, resulted in weight loss while improving HbA1c levels without increasing hypoglycemia in adults with T1D. This article is protected by copyright. All rights reserved.

PMID:36314293 | DOI:10.1111/dom.14911

Skin Res Technol. 2022 Oct 31. doi: 10.1111/srt.13225. Online ahead of print.

ABSTRACT

BACKGROUND: Radiofrequency (RF) devices have been used for skin rejuvenation and treating skin laxity. It may also be effective for senile purpura (SP) based on its action of promoting neocollagenesis with minimal epidermal damage. This study aimed to evaluate the efficacy and safety of microneedle RF for treating SP of the forearms in elderly.

MATERIAL AND METHODS: In this prospective study, 23 patients who underwent a single session of microneedle RF device (GENIUS, Lutronic Co., Korea) therapy for SP were enrolled. Histopathological features were assessed 1 week before and 8 weeks after therapy. The total amount of collagen and elastic fibers were measured using the computer vision method, and epidermal thickness and the number of blood vessels were analyzed using ImageJ. The clinical improvements were evaluated by blinded evaluators and the patients using investigator global assessment (IGA) and patient global assessment (PGA), respectively. Data regarding the number of purpuric lesions and the size of the largest lesion were collected via a telephone survey.

RESULTS: The total amount of collagen and elastic fibers, and mean epidermal thickness tended to improve after RF treatments, although they did not reach statistical significance. The locally estimated scatterplot smoothing curve showed decreasing tendency in both size and number of purpuras as weeks progressed. PGA showed very satisfied in 65% of patients and IGA showed 39% near-total improvement and 43% marked improvement. There were no serious adverse events.

CONCLUSIONS: Microneedle RF therapy induces remodeling of dermal circumstances with minimal epidermal impairment. It may be a promising therapeutic option for SP.

PMID:36314292 | DOI:10.1111/srt.13225

Nanoscale. 2022 Oct 31. doi: 10.1039/d2nr04668g. Online ahead of print.

ABSTRACT

Designing nano-engineered particles capable of the delivery of therapeutic and diagnostic agents to a specific target remains a significant challenge. Understanding how interactions between particles and cells are impacted by the physicochemical properties of the particle will help inform rational design choices. Mathematical and computational techniques allow for details regarding particle-cell interactions to be isolated from the interwoven set of biological, chemical, and physical phenomena involved in the particle delivery process. Here we present a machine learning framework capable of elucidating particle-cell interactions from experimental data. This framework employs a data-driven modelling approach, augmented by established biological knowledge. Crucially, the model of particle-cell interactions learned by the framework can be interpreted and analysed, in contrast to the ‘black box’ models inherent to other machine learning approaches. We apply the framework to association data for thirty different particle-cell pairs. This library of data contains both adherent and suspension cell lines, as well as a diverse collection of particles. We consider hyperbranched polymer and poly(methacrylic acid) particles, from 6 nm to 1032 nm in diameter, with small molecule, monoclonal antibody, and peptide surface functionalisations. Despite the diverse nature of the experiments, the learned models of particle-cell interactions for each particle-cell pair are remarkably consistent: out of 2048 potential models, only four unique models are learned. The models reveal that nonlinear saturation effects are a key feature governing particle-cell interactions. Further, the framework provides robust estimates of particle performance, which facilitates quantitative evaluation of particle design choices.

PMID:36314284 | DOI:10.1039/d2nr04668g

Health Econ. 2022 Oct 31. doi: 10.1002/hec.4626. Online ahead of print.

ABSTRACT

This paper re-examines a well-established hypothesis postulating that life expectancy augments incentives for human capital accumulation, leading to global income differences. A major distinguishing feature of the current study is to estimate heterogeneous panel data models under a common factor framework, which explicitly accounts for parameter heterogeneity, unobserved common factors (UCFs), and variables’ non-stationarity. In sharp contrast to most previous studies, I find that the impact of health improvements on human capital accumulation turns out to be imprecisely estimated at conventionally accepted levels of statistical significance. I demonstrate that conventional estimates of the educational returns to rising longevity are derived from estimating misspecified models at least partially due to parameter heterogeneity and the presence of UCFs.

PMID:36314282 | DOI:10.1002/hec.4626

Ann Pharmacother. 2022 Oct 29:10600280221133577. doi: 10.1177/10600280221133577. Online ahead of print.

ABSTRACT

BACKGROUND: No study has yet systematically evaluated the effect of antidiabetic therapy on clinical outcomes of COVID-19 patients with type 2 diabetes (T2D).

OBJECTIVE: We aimed to evaluate the effect of different antidiabetic therapy on clinical outcomes of COVID-19 patients with T2D.

METHODS: We comprehensively retrieved the published research which examined the effect of antidiabetic therapy on clinical outcomes of COVID-19 patients with T2D. The odds ratio (OR) and its 95% confidence interval (95% CI) for clinical outcomes were calculated using the random-effects model, and meta-regression was adopted to evaluate the potential sources of heterogeneity between studies.

RESULTS: A total of 54 studies were included in this study. We found that the use of metformin (OR = 0.66, 95% CI: 0.58-0.75), SGLT-2i (OR = 0.80, 95% CI: 0.73-0.88), and GLP-1ra (OR = 0.83, 95% CI: 0.70-0.98) were significantly associated with lower mortality risk in COVID-19 patients with T2D, while insulin use might unexpectedly increase the ICU admission rate (OR = 2.32, 95% CI: 1.34-4.01) and risk of death (OR = 1.52, 95% CI: 1.32-1.75). No statistically significant associations were identified for DPP-4i, SUs, AGIs, and TZDs.

CONCLUSION AND RELEVANCE: We demonstrated that the usage of metformin, SGLT-2i, and GLP-1ra could significantly decrease mortality in COVID-19 patients with T2D. The heterogeneity across the studies, baseline characteristics of the included patients, shortage of dosage and the duration of antidiabetic drugs and autonomy of drug selection might limit the objectivity and accuracy of results. Further adequately powered and high-quality randomized controlled trials are warranted for conclusive findings.

PMID:36314281 | DOI:10.1177/10600280221133577

Ann Pharmacother. 2022 Oct 29:10600280221132851. doi: 10.1177/10600280221132851. Online ahead of print.

ABSTRACT

BACKGROUND: Opioid-induced constipation (OIC) may occur in up to 81% of critically ill patients and can lead to many complications. Opioid antagonists are a reasonable approach and may be used for managing OIC.

OBJECTIVE: The purpose of this study was to assess the efficacy of enteral naloxone (NLX) versus subcutaneous methylnaltrexone (MNTX) for the management of OIC in critically ill patients.

METHODS: A retrospective analysis was conducted on adult patients who received NLX or MNTX and a continuous opioid infusion for at least 48 hours. The primary end point was time to resolution of constipation, defined as hours to first bowel movement (BM) after the first dose of an opioid antagonist. Reversal of analgesia was assessed by comparing the total number of morphine milligram equivalents (MME) 24 hours preopioid and postopioid antagonist administration. Univariate and multivariate analyses were conducted to assess treatment response within 48 hours.

RESULTS: Baseline characteristics were similar between patients receiving NTX (n = 89) and MNTX (n = 71). However, the time to the first BM with NLX was 18 hours compared with 41 hours with MNTX (P = 0.004). There was no difference in MME requirements 24 hours pre/post NLX or MNTX administration. Naloxone administration was identified as a statistically significant predictor of BM within 48 hours (odds ratio [OR] = 2.68 [1.33-5.38]).

CONCLUSION AND RELEVANCE: The time to first BM was shorter with enteral NLX. Both NLX and MNTX appear to be effective for the management of OIC without causing reversal of analgesia. Future controlled, prospective trials comparing these agents are warranted.

PMID:36314271 | DOI:10.1177/10600280221132851