Tag: pubmed

Int J Epidemiol. 2022 Mar 1:dyac023. doi: 10.1093/ije/dyac023. Online ahead of print.

ABSTRACT

BACKGROUND: The association between body mass index (BMI) and oesophageal cancer (OC) has been consistently negative among Asians, whereas different associations based on histological OC subtypes have been observed in Europeans and North Americans. We examined the association between BMI and OC mortality in the Asia Cohort Consortium.

METHODS: We performed a pooled analysis to evaluate the association between BMI and OC mortality among 842 630 Asians from 18 cohort studies. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs.

RESULTS: A wide J-shaped association between BMI and overall OC mortality was observed. The OC mortality risk was increased for underweight (BMI <18.5 kg/m2: HR = 2.20, 95% CI 1.80-2.70) and extreme obesity (BMI ≥35 kg/m2: HR = 4.38, 95% CI 2.25-8.52) relative to the reference BMI (23-25 kg/m2). This association pattern was confirmed by several alternative analyses based on OC incidence and meta-analysis. A similar wide J-shaped association was observed in oesophageal squamous cell carcinoma (OSCC). Smoking and alcohol synergistically increased the OC mortality risk in underweight participants (HR = 6.96, 95% CI 4.54-10.67) relative to that in reference BMI participants not exposed to smoking and alcohol.

CONCLUSION: Extreme obesity and being underweight were associated with an OC mortality risk among Asians. OC mortality and BMI formed a wide J-shaped association mirrored by OSCC mortality. Although the effect of BMI on OSCC and oesophageal adenocarcinoma mortality can be different in Asians, further research based on a large case-control study is recommended.

PMID:35229874 | DOI:10.1093/ije/dyac023

Medwave. 2021 Oct 26;21(9):e8481. doi: 10.5867/medwave.2021.09.2119.

ABSTRACT

OBJECTIVE: To determine the scientific production of doctoral graduates in Peru.

METHODS: We made a descriptive cross-sectional study with a quantitative analysis approach of the scientific production of doctoral graduates in all areas of science registered in the National Council of Science, Technology and Technological Innovation of Peru.

RESULTS: We analyzed the scientific production of 942 doctoral graduates with a median time since the graduation of 84 months (interquartile range: 36 to 132). In total, 532 (56.48%) had published an article in their lifetime. The median of published articles was four (interquartile range: 2 to 12), and the median H-index of the doctoral graduates who had published was two (interquartile range: 1 to 5). We found that the number of publications and H-index was statistically different according to the doctorate area of science (p < 0.05 for both). Natural Sciences (69.13%), Engineering (67.47%), and Health Sciences (67.08%) had the highest proportion of doctoral graduates with at least one publication. Regarding gender and university of origin (foreign or Peruvian), it was found a difference concerning the number of articles published and the H-index (p < 0.05 for both) being that male and doctoral graduates with a foreign doctoral degree had higher scientific production.

CONCLUSIONS: Only six out of 10 Peruvian doctoral graduates have published at some point in their life. The areas of science with the highest production by doctoral graduates were Natural Sciences, Engineering, and Health Sciences. There is higher scientific production in males and graduates from a foreign university.

PMID:35229830 | DOI:10.5867/medwave.2021.09.2119

Int J Epidemiol. 2022 Mar 1:dyac018. doi: 10.1093/ije/dyac018. Online ahead of print.

NO ABSTRACT

PMID:35229872 | DOI:10.1093/ije/dyac018

Neurosurgery. 2022 Mar 3. doi: 10.1227/NEU.0000000000001869. Online ahead of print.

ABSTRACT

BACKGROUND: Local management for vestibular schwannoma (VS) is associated with excellent local control with focus on preserving long-term serviceable hearing. Fractionated proton radiation therapy (FPRT) may be associated with greater hearing preservation because of unique dosimetric properties of proton radiotherapy.

OBJECTIVE: To investigate hearing preservation rates of FPRT in adults with VS and secondarily assess local control and treatment-related toxicity.

METHODS: A prospective, single-arm, phase 2 clinical trial was conducted of patients with VS from 2010 to 2019. All patients had serviceable hearing at baseline and received FPRT to a total dose of 50.4 to 54 Gy relative biological effectiveness (RBE) over 28 to 30 fractions. Serviceable hearing preservation was defined as a Gardner-Robertson score of 1 to 2, measured by a pure tone average (PTA) of ≤50 dB and a word recognition score (WRS) of ≥50%.

RESULTS: Twenty patients had a median follow-up of 4.0 years (range 1.0-5.0 years). Local control at 4 years was 100%. Serviceable hearing preservation at 1 year was 53% (95% CI 29%-76%), and primary end point was not yet reached. Median PTA and median WRS both worsened 1 year after FPRT (P < .0001). WRS plateaued after 6 months, whereas PTA continued to worsen up to 1 year after FPRT. Median cochlea D90 was lower in patients with serviceable hearing at 1 year (40.6 Gy [RBE] vs 46.9 Gy [RBE]), trending toward Wilcoxon rank-sum test statistical significance (P = .0863). Treatment was well-tolerated, with one grade 1 cranial nerve V dysfunction and no grade 2+ cranial nerve dysfunction.

CONCLUSION: FPRT for VS did not meet the goal of serviceable hearing preservation. Higher cochlea doses trended to worsening hearing preservation, suggesting that dose to cochlea correlates with hearing preservation independent of treatment modality.

PMID:35229827 | DOI:10.1227/NEU.0000000000001869

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1111-1117. doi: 10.4103/1319-2442.338284.

ABSTRACT

Acute kidney injury (AKI) in postpartum is a rare, but deadly complication of pregnancy. It has great impact on maternal and fetal outcomes. The study aimed to study the incidence and etiological profile with outcomes of postpartum AKI patients and to see whether need for hemodialysis (HD) alters the outcome. This is a retrospective observation study done in a tertiary care center at the Department of Nephrology, Ramkrishnan Care Hospital, Raipur, Chhattisgarh, India. All postpartum women suffering from AKI between May 2011 and May 2017 were included in this study. Demographic, clinical, and laboratory data of the patients were included. Outcome variables including maternal and fetal mortality with renal outcome during discharge and follow-up for three months were noted. Patients were divided into two groups: Group 1 underwent HD and Group 2 was managed conservatively. Statistical analysis was done on the Statistical Package for the Social Sciences software version 17.0. Categorical data were expressed as ratio and proportions, while continuous data were expressed as mean plus standard deviation (SD). Quantitative data were analyzed by percentage, mean, SD, and t-test. Qualitative data were analyzed by Chi-square test. The incidence of postpartum AKI was 3.26% and the mean age of the study population was 27.3 ± 4.77 years. Multifactorial (53.27%) etiology was the most cause of postpartum AKI, and the second was puerperal sepsis (32.7%). Seventy-three (68.22%) patients had undergone HD. Four (4.47%) patients require lifelong HD. Renal biopsy was done in seven patients, three had cortical necrosis among fetal outcomes, total live births were 92 (85.98%), and 15 (14.01%) died in the neonatal period. There was no statistically significant difference between Group 1 and Group 2 in etiological profile (P >0.55), maternal mortality (P >0.66), and renal outcome (P >0.11). Postpartum AKI was associated with poor maternal outcome and renal recovery. Maternal mortality and renal recovery were not affected by need of dialysis in our patients. Proper antenatal care and peripartum monitoring with practicing aseptic precaution will definitely help in reduction of postpartum AKI and maternal mortality in our state.

PMID:35229810 | DOI:10.4103/1319-2442.338284

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1073-1088. doi: 10.4103/1319-2442.338281.

ABSTRACT

There is a paucity of data on epidemiology along with an incomplete registry of end-stage kidney disease (ESKD), nephrologist workforce, and variability among the countries of Gulf Cooperation Council (GCC). The study is an observation, descriptive study which aimed to describe current ESKD burden, nephrologist density, and kidney care infrastructure in GCC. Responses to a questionnaire-based survey obtained from representatives of the Nephrology Societies of GCC countries were analyzed. The categorical variables were compared using Chi-square test. A P = 5% was considered as significant. The mean prevalence of ESKD per million populations (pmp) was 551, highest in Oman (1000/pmp), least in Qatar (347/pmp). Predominant etiology in GCC was diabetes mellitus (DM) and hypertension (HTN) (100%, each), followed by chronic glomerulonephritis (66.7%). A transplant registry was maintained by all GCC countries. Hemodialysis (HD) (67.2%) was the most opted modality of kidney replacement therapy (KRT), followed by kidney transplantation (22%) and peritoneal dialysis (9.6%); 1.0% of patients opted for conservative management. Unplanned initiation of HD was three times more common. The access distribution among incident and prevalent HD patients respectively was (i) nontunneled central catheter (nTCC) (58.7 ± 36.6 vs. 1.5 ± 1.5), (ii) tunneled central catheter (23.5 ± 29.9 vs. 33.6 ± 10.0), and (iii) arteriovenous fistula (17.3± 14.4 vs. 57.8 ± 11.86). Death and transplantation were the reasons for dropout from HD. GCC has adequate kidney care infrastructure. There are 1686 nephrologists [range: Bahrain 9, Kingdom of Saudi Arabia (KSA) 1279]. Qatar, KSA, and Kuwait provide training in kidney biopsy; all countries except Bahrain have formal training programs for nTCC placement. ESKD prevalence is high, DM, HTN; glome-rulonephritis (GN) is the most common causes. The need for KRT is expected to rise in GCC. HD is the predominant KRT modality with a high prevalence of dialysis catheters as vascular access.

PMID:35229807 | DOI:10.4103/1319-2442.338281

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1065-1072. doi: 10.4103/1319-2442.338280.

ABSTRACT

Kidney transplant remains the definitive treatment for patients with end-stage renal disease. A retrospective cohort was conducted in Dr. Selma Center for Kidney Diseases (DSCKD) to determine the pattern of follow-up and outcomes of adult kidney transplant recipients (KTRs) on long-term follow-up. Patients presented for follow-up during the period from January to June 2018 were studied regarding their demographic features, kidney transplant surgery, immunosuppressive therapy, graft function, and post-transplant complications. Data analysis was done using the Statistical Package for the Social Sciences version 16.0. During the study period, a total of 941 adult and pediatric KTR presented to DSCKD for follow-up. Only 792 KTRs were included in the study; those were adults, with their first kidney transplant, completed one year post-transplant, and agreed for enrollment. The mean age of the studied population was 47 ± 4.3 years. The majority were males, 74.2%. The median duration of follow-up was 7.4 years (interquartile range 3-11). Most transplants were through living-related donations, 78.8%. The combination of prednisolone, tacrolimus, and azathioprine remains the most common immunosuppressive regimen prescribed; delivered to 47.5% of recipients. Post-transplant complications were predominantly recurrent infections, diabetes mellitus, and hyperlipidemia seen in 54.5%, 42.4%, and 24.7% of recipients, respectively. On cross-comparisons living unrelated donor transplant recipients were found to have increased post-transplant complications, with a reduced kidney graft function at the end of the 1^st year and throughout follow-up, when compared to living related donor transplant recipients. A prospective multi-center study with long-term follow-up remains essential for further evaluation of the long-term outcomes of the KTR in Sudan.

PMID:35229806 | DOI:10.4103/1319-2442.338280

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1054-1064. doi: 10.4103/1319-2442.338279.

ABSTRACT

Renal transplantation is the ideal therapeutic implement for end-stage renal disease patients. However, late kidney graft defeat remains a main challenge. Torque teno virus (TTV) is a small DNA virus whose replication is strictly related to person immune status besides TTV Antigens could prevent organ rejection by regulating both adaptive and innate immunity through interfering with NF-κB pathway which decrease interleukin-6 (IL-6) levels in renal transplanted patients. This cross-sectional study was conducted eighty serum samples were collected renal transplant recipients, DNA was extracted and the viral DNA was detected and quantified by quantitative polymerase chain reaction (PCR) for human cytomegalovirus (CMV) and real-time PCR for TTV. In addition, enzyme-linked immunosorbent assays (ELISA) were used for the detection of TTV antigen and IL-6 levels were also done. Result of PCR showed that 25% and 56.25% of renal transplantation patients had positive for CMV and TTV viremia. CMV viremia was positive in 20% of patients who have positive result to TTV-DNA, which was statistically nonsignificant. Results of ELISA presented that TTV-Ag was positive in 10% of renal transplantation patients, while IL-6 level was very low in patients who have positive results to present of TTV-Ag which was significantly lower in those patients (P = 0.008). In conclusion, TTV could have not an association with reactivation of CMV in renal transplant patients and the presence of TTV-Ag reduce renal rejection by decreasing of IL-6 levels which might be an indicator of allograft status.

PMID:35229805 | DOI:10.4103/1319-2442.338279

Pest Manag Sci. 2022 Mar 1. doi: 10.1002/ps.6852. Online ahead of print.

NO ABSTRACT

PMID:35229453 | DOI:10.1002/ps.6852

J Clin Hypertens (Greenwich). 2022 Mar 1. doi: 10.1111/jch.14445. Online ahead of print.

ABSTRACT

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) both inhibit the renin-angiotensin system (RAS) but have different sites of action. Whether clinically meaningful differences exist is still debated. The authors set up a population-based nationwide retrospective cohort study with at least 5 years of follow-up based on the comprehensive French Health Insurance Database linked to the French hospital discharge database. Patients aged 50 or above, identified as ARB or ACE inhibitor new users in 2009 (at least one delivery during the year and no such delivery in 2008) were eligible. Exclusion criteria included history of cancer, cardiovascular disease, or chronic renal insufficiency. Main outcome measure was overall mortality. Secondary outcomes were cardiovascular deaths, major cardiovascular events, and major or other cardiovascular events. Out of 407 815 eligible patients, 233 682 (57%) were ARB users; two-third had no previous exposure to antihypertensive drug. Based on propensity-score based Cox model, ARB new user group had a better overall (HR: .878, 95%CI, .854 to .902), and cardiovascular (HR: .841, 95%CI, .800 to .84) survival and had a lower risk for major cardiovascular events (HR: .886, 95%CI, .868 to .905). Statistically significant quantitative interactions were detected with diabetes. Considering subgroup analyses, ARBs had a better survival than ACE inhibitors in nondiabetic patients.

PMID:35229448 | DOI:10.1111/jch.14445