Tag: pubmed

Respir Med. 2021 Sep 10;188:106609. doi: 10.1016/j.rmed.2021.106609. Online ahead of print.

ABSTRACT

BACKGROUND: Radial endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) facilitates the diagnosis of peripheral lung lesions. However, methods to prevent infectious complications afterwards have not been well established. Therefore, we analyzed the efficacy of short-term oral antibiotics for preventing infectious complications.

METHODS: We retrospectively analyzed 484 patients. Patients who underwent rEBUS-TBB from March 2018 to March 2019 did not receive prophylactic antibiotics (“no prophylactic” group, n = 233), while patients who underwent rEBUS-TBB from April 2019 to March 2020 did receive prophylactics (oral amoxicillin/clavulanate for 3 days; “prophylactic” group, n = 251). Multivariable logistic regression was used to identify independent factors for infectious complications.

RESULTS: The median age was 66 years (IQR: 59-74 years), and 58.9% were male. Slightly over half of the patients (54.4%) were previous or current smokers. In 13% (n = 63) of patients, the procedure was performed using a guide sheath. Infectious complications occurred in 12 (5.2%) and 2 (0.8%) cases in the no prophylactic and prophylactic groups, respectively. In multivariable analysis, infectious complications were significantly associated with a cavity or low-density attenuation (LDA) of the lesion, and with obstructive pneumonic consolidation, but not with prophylactic antibiotics. In subgroup analysis, infectious complications occurred less often when prophylactic antibiotics were used in patients with at least one risk factor (22.4% vs. 0%, p = 0.005).

CONCLUSIONS: The risk factors for infectious complications were cavities, LDA in the lesion, and obstructive pneumonic consolidation. Use prophylactic antibiotics might reduce incidence of infectious complications in the presence of these risk factors.

PMID:34520893 | DOI:10.1016/j.rmed.2021.106609

Soc Sci Med. 2021 Sep 8;287:114379. doi: 10.1016/j.socscimed.2021.114379. Online ahead of print.

ABSTRACT

Efforts to mitigate the spread of COVID-19 rely on trust in public health organizations and practices. These practices include contact tracing, which requires people to share personal information with public health organizations. The central role of trust in these practices has gained more attention during the pandemic, resurfacing endemic questions about public trust and potential racial trust disparities, especially as they relate to participation in public health efforts. Using an explanatory mixed methods design, we conducted quantitative analysis of state-level survey data in the United States from a representative sample of Michigan residents (n = 1000) in May 2020. We used unadjusted and adjusted linear regressions to examine differences in trust in public health information and willingness to participate in public health efforts by race. From July to September 2020, we conducted qualitative interviews (n = 26) to further explain quantitative results. Using unadjusted linear regression, we observed higher willingness to participate in COVID-19 public health efforts among Black survey respondents compared to White respondents. In adjusted analysis, that difference disappeared, yielding no statistically significant difference between Black and White respondents in either trust in public health information sources or willingness to participate. Qualitative interviews were conducted to explain these findings, considering their contrast with assumptions that Black people would exhibit lower trust in public health organizations during COVID-19. Altruism, risk acknowledgement, trust in public health organizations during COVID-19, and belief in efficacy of public health efforts contributed to willingness to participate in public health efforts among interviewees. Our findings underscore the contextual nature of trust, and the importance of this context when analyzing protective health behaviors among communities disproportionately affected by COVID-19. Assumptions about mistrust among Black individuals and communities may be inaccurate because they overlook the specific context of the public health crisis. These findings are important because they indicate that Black respondents are exhibiting strategic trust during COVID-19 despite systemic, contemporary, and historic barriers to trust. Conceptual specificity rather than blanket generalizations is warranted, especially given the harms of stereotyping and discrimination.

PMID:34520940 | DOI:10.1016/j.socscimed.2021.114379

Photodiagnosis Photodyn Ther. 2021 Sep 11:102533. doi: 10.1016/j.pdpdt.2021.102533. Online ahead of print.

ABSTRACT

AIM: We aimed to perform structural analysis of the choroid in adults with different refractive status.

MATERIALS AND METHODS: A prospective, comparative study of 100 right eyes of 100 patients ages 18-40 years was conducted. The patients were divided into four groups according to spherical equivalent (SE): Group 1: -0.5 and above, low-to-moderate myopia; Group 2: -6 and above, high myopia; Group 3: +0.5 and above, hyperopia; Group 4: +/- 0.5, emmetropia. With the images obtained using enhanced depth imaging optical coherence tomography (EDI-OCT), the total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascular index (CVI) were calculated using the binarization method. The anterior chamber depth (ACD), axial length (AL), and central corneal thickness (CCT) values were measured by optical biometry. All parameters were compared between groups. The correlation of biometric parameters with CVI was examined.

RESULTS: Parameters were found to be statistically different between the four groups. TCA, LA, and SA values were the highest in Group 3 and lowest in Group 2. L/S ratio and CVI values in Group 3 were significantly lower than in the other groups. There was a negative correlation between AL with SE and CT, and no correlation between the CVI and other parameters.

CONCLUSION: CVI decreases when emmetropization is disrupted and changes to hypermetropia or myopia. The reason for the decrease in myopia is the reduction of the luminal area, while in hyperopia it is due to an increase in the stromal area. When there is a shift toward myopia, there is a decrease in the TCA, but the CVI does not change significantly. Unlike CT, the CVI is not affected by factors such as SE and AL; therefore, the CVI can be a useful parameter for examining choroidal changes in refractive errors.

PMID:34520880 | DOI:10.1016/j.pdpdt.2021.102533

Photodiagnosis Photodyn Ther. 2021 Sep 12:102534. doi: 10.1016/j.pdpdt.2021.102534. Online ahead of print.

ABSTRACT

BACKGROUND: Curcuminoids have been designed not only to improve chemical and metabolic stability of curcumin (CUR), but also to increase its antimicrobial activity, without affecting its ability as photosensitizer agent in antimicrobial photodynamic therapy (aPDT) with light emitting diode (LED). This study evaluated the antimicrobial and antibiofilm action of curcumin analog DHC (or 3,3′-dihydroxycurcumin), submitted or not to LED irradiation, on microorganisms of endodontic importance and its influence on fibroblasts viability.

METHODS: DHC was synthetized by modified Pablon’s methodology and the experiments were conducted under irradiation or not with indium gallium nitride-based LED (465-485nm, 100 mW/cm², 0.78 cm²,60 s). The antimicrobial activity of CUR and DHC were determined by the Minimum Inhibitory and Bactericidal Concentration assays against Gram-positive and Gram-negative bacteria and the effect of both compounds on fibroblast viability was tested using colorimetric assays. They were also evaluated on 72h and 7days single-species biofilms and on 14 days multispecies biofilms formed inside dentin tubules by bacterial colonies counts and confocal microscopy, respectively. Data were analyzed statistically considering p<0.05.

RESULTS: DHC had bactericidal effect against all bacteria tested higher than CUR, in planktonic conditions. CUR and DHC (at 39 and 19 μg/mL, respectively) were cytocompatible and LED irradiation reduced fibroblast viability, regardless of compound. CUR and DHC reduced the growth of single-species biofilms and the effect of aPDT was bacteria dependent. DHC reduced more than 70% of microorganisms from multispecies biofilms, superior to CUR effect.

CONCLUSIONS: DHC showed low cytotoxicity and antibiofilm effect similar to curcumin, when submitted or not to aPDT, and could be further explored as bioactive compound for endodontic purposes.

PMID:34520879 | DOI:10.1016/j.pdpdt.2021.102534

Infect Genet Evol. 2021 Sep 11:105082. doi: 10.1016/j.meegid.2021.105082. Online ahead of print.

ABSTRACT

This study was to find out novel miRNAs whether could be used as diagnostic or prognostic biomarkers in sepsis. We used miRNAs microarray assays and further confirmed the levels of miRNAs in 151 septic patients’ plasma. 56 miRNAs were up-regulated and 74 miRNAs down-regulated in septic patients compared with the healthy volunteers. But only miR-519c-5p and miR-3622b-3p were up-regulated in both septic and septic shock patients. The levels of miR-519c-5p and miR-3622b-3p were statistically higher in 151 septic patients than healthy controls on day 1. The AUC for miR-519c-5p was 0.79 (95% CI, 0.688-0.892, p = 0.001) in the diagnosis of sepsis, and the AUC for miR-3622b-3p 0.752 (95% CI, 0.622-0.881, p = 0.003). The AUC for the combination of these two miRNAs was 0.831 (95% CI, 0.74-0.923, p < 0.001). Besides, the AUC for miR-519c-5p was 0.597 (p = 0.043) in predicting 28-day mortality. MiR-519c-5p, miR-3622b-3p were novel biomarkers for diagnosing septic patients. High miR-519c-5p levels suggest a worse short-term prognosis. CLINICAL TRIAL REGISTRATION INFORMATION: Name of the registry: Diagnostic and prognostic value of circulating miRNA in patients with sepsis; Trial registration ID: ChiCTR-DDD-17,013,150; registered 30 October 2017; http://www.chictr.org.cn/edit.aspx?pid=22528&htm=4.

PMID:34520874 | DOI:10.1016/j.meegid.2021.105082

Photodiagnosis Photodyn Ther. 2021 Sep 11:102531. doi: 10.1016/j.pdpdt.2021.102531. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the choroidal structural parameters, peripapillary retinal nerve fiber layer (RNFL) thickness, and optic density index (ODI) and their correlations in patients with migraines.

METHODS: Twenty-eight newly diagnosed migraine patients and 28 age-matched healthy controls were included in this prospective cross-sectional study. The enhanced depth-optical coherence tomography images were evaluated. The choroidal area (CA) was binarized to the luminal area (LA) and stromal area (SA) using Image J. The choroidal vascularity index (CVI), the mean peripapillary RNFL thickness, superior-inferior-nasal-temporal quadrant RNFL thicknesses, and the ODI were compared statistically.

RESULTS: The difference in the mean CVI between the patient group and controls reached a statistical significance (p=0.035). The mean RNFL thickness was significantly decreased in patients with migraines compared with the controls (p=0.040). The mean RNFL thickness in the superior, temporal, and inferior quadrants was significantly decreased in the patient group in comparison to the control subjects (p=0.030, p=0.001, and p=0.022, respectively). There were no significant differences between the migraine group and the controls for the mean ODI of RNFL (p=0.399).

CONCLUSION: The CVI and the RNFL thickness except for the nasal quadrant were significantly decreased in newly diagnosed migraine patients.

PMID:34520878 | DOI:10.1016/j.pdpdt.2021.102531

J Clin Epidemiol. 2021 Sep 11:S0895-4356(21)00284-5. doi: 10.1016/j.jclinepi.2021.09.004. Online ahead of print.

NO ABSTRACT

PMID:34520848 | DOI:10.1016/j.jclinepi.2021.09.004

Infect Genet Evol. 2021 Sep 11:105081. doi: 10.1016/j.meegid.2021.105081. Online ahead of print.

ABSTRACT

Coronavirus disease 2019 (COVID-19) has harshly impacted Italy since its arrival in February 2020. In particular, provinces in Italy’s Central and Northern macroregions have dealt with disproportionately greater case prevalence and mortality rates than those in the South. In this paper, we compare the morbidity and mortality dynamics of 16th and 17th century Plague outbreaks with those of the ongoing COVID-19 pandemic across Italian regions. We also include data on infectious respiratory diseases which are presently endemic to Italy in order to analyze the regional differences between epidemic and endemic disease. A Growth Curve Analysis allowed for the estimation of time-related intercepts and slopes across the 16th and 17th centuries. Those statistical parameters were later incorporated as criterion variables in multiple General Linear Models. These statistical examinations determined that the Northern macroregion had a higher intercept than the Southern macroregion. This indicated that provinces located in Northern Italy had historically experienced higher plague mortalities than Southern polities. The analyses also revealed that this geographical differential in morbidity and mortality persists to this day, as the Northern macroregion has experienced a substantially higher COVID-19 mortality than the Southern macroregion. These results are consistent with previously published analyses. The only other stable and significant predictor of epidemic disease mortality was foreign urban potential, a measure of the degree of interconnectedness between 16th and 17th century Italian cities. Foreign urban potential was negatively associated with plague slope and positively associated with plague intercept, COVID-19 mortality, GDP per capita, and immigration per capita. Its substantial contribution in predicting both past and present outcomes provides a temporal continuity not seen in any other measure tested here. Overall, this study provides compelling evidence that temporally stable geographical factors, impacting both historical and current foreign pathogen spread above and beyond other hypothesized predictors, underlie the disproportionate impact COVID-19 has had throughout Central and Northern Italian provinces.

PMID:34520873 | DOI:10.1016/j.meegid.2021.105081

Ann Oncol. 2021 Sep 11:S0923-7534(21)04478-1. doi: 10.1016/j.annonc.2021.09.003. Online ahead of print.

ABSTRACT

BACKGROUND: Current genetic and genomic tests measuring homologous recombination deficiency (HRD) show limited predictive value. This study compares the performance of an immunohistology-based RAD51 test with genetic/genomic tests to identify patients with HRD primary triple-negative breast cancer (TNBC) and evaluates its accuracy to select patients sensitive to platinum-based neoadjuvant chemotherapy (NACT).

PATIENTS AND METHODS: This is a retrospective, blinded, biomarker analysis from the GeparSixto randomized clinical trial. TNBC patients received neoadjuvant paclitaxel plus Myocet-nonpegylated liposomal doxorubicin (PM) or PM plus carboplatin (PMCb), both arms including bevacizumab. Formalin-fixed paraffin-embedded (FFPE) tumor samples were laid on tissue microarrays. RAD51, BRCA1 and γH2AX were quantified using an immunofluorescence assay. The predictive value of RAD51 was assessed by regression models. Concordance analyses were performed between RAD51 score and tumor BRCA (tBRCA) status or genomic HRD score (myChoiceHRD). Associations with pathological complete response (pCR) and survival were studied. Functional HRD was pre-defined as a RAD51 score ≤10% (RAD51-low).

RESULTS: Functional HRD by RAD51-low was evidenced in 81/133 tumors (61%). RAD51 identified 93% tBRCA-mutated tumors and 45% non-tBRCA mutant cases as functional HRD. The concordance between RAD51 and genomic HRD was 87% (95%CI 79-93%). In patients with RAD51-high tumors, pCR was similar between treatment arms (PMCb 31% vs PM 39%, odds ratio (OR) 0.71, 0.23-2.24, p=0.56). Patients with RAD51-low tumors benefited from PMCb (pCR 66% vs 33%, OR 3.96, 1.56-10.05, p=0.004; interaction test p=0.02). This benefit maintained statistical significance in the multivariate analysis. Carboplatin addition showed similar disease-free survival in RAD51-high (hazard ratio (HR) 0.40, log-rank p=0.11) and RAD51-low (0.45, p=0.11) groups.

CONCLUSIONS: The RAD51 test identifies tumors with functional HRD and is highly concordant with tBRCA mutation and genomic HRD. RAD51 independently predicts clinical benefit from adding Cb to NACT in TNBC. Our results support further development to incorporate RAD51 testing in clinical decision-making.

PMID:34520831 | DOI:10.1016/j.annonc.2021.09.003

J Clin Epidemiol. 2021 Sep 11:S0895-4356(21)00288-2. doi: 10.1016/j.jclinepi.2021.09.008. Online ahead of print.

ABSTRACT

OBJECTIVE: No clear guidance exists on handling missing data at each stage of developing, validating and implementing a clinical prediction model (CPM). We aimed to review the approaches to handling missing data that underly the CPMs currently recommended for use in UK healthcare.

STUDY DESIGN AND SETTING: A descriptive cross-sectional meta-epidemiological study aiming to identify CPMs recommended by the National Institute for Health and Care Excellence (NICE), which summarized how missing data is handled across their pipelines.

RESULTS: 23 CPMs were included through ‘sampling strategy’. Six missing data strategies were identified: complete case analysis (CCA), multiple imputation, imputation of mean values, k-nearest neighbours imputation, using an additional category for missingness, considering missing values as risk-factor-absent. 52% of the development articles and 48% of the validation articles did not report how missing data were handled. CCA was the most common approach used for development (40%) and validation (44%). At implementation, 57% of the CPMs required complete data entry, whilst 43% allowed missing values. 3 CPMs had consistent paths in their pipelines.

CONCLUSION: A broad variety of methods for handling missing data underly the CPMs currently recommended for use in UK healthcare. Missing data handling strategies were generally inconsistent. Better quality assurance of CPMs needs greater clarity and consistency in handling of missing data.

PMID:34520847 | DOI:10.1016/j.jclinepi.2021.09.008