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Nevin Manimala Statistics

Tolerance to glucose and lipid high metabolic reactions after burns in an obese rat model

J Burn Care Res. 2021 Sep 14:irab163. doi: 10.1093/jbcr/irab163. Online ahead of print.

ABSTRACT

The goal of this study was to determine what effect obese body weight and a burn injury can have on the metabolism of glucose and lipids in rats. We used a 3*3 factorial model design to provide basic glucose and lipid metabolic data characterizing the interaction between different weight and burn injury groups. Two hundred Sprague Dawley (SD) rats were categorized into three weight groups (normal, overweight, obese) and then further divided into control, second degree, and third degree burn groups. Our model compared interactions between weight and burn injury factors according to the above groups. Blood glucose and lipid metabolism indicators were monitored on the 1st, 3rd, 7th and 14th days after burn injury occurred, and burned skin and blood samples were collected for testing. Compared with the normal weight group, the overweight group’s fast blood glucose (FBG), fast insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) were higher (P<0.05), and FBG in the obese group was higher than the normal weight group (P<0.05).Burn injuries combined with obese body weight had an interactive effect on FBG, FINS and HOMA-IR after burn injury (P<0.05). Burn injury combined with obese body weight had an interaction on low density lipoprotein cholesterol (LDL-C) on the 3rd day after burn injury (P<0.05). Burn injury combined with obese weight had no interaction on triglyceride (TRG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) (P>0.05).Rats in the overweight and obese weight groups were observed to develop an adaptation and tolerance to a higher metabolic rate after burn injuries occurred.

PMID:34520555 | DOI:10.1093/jbcr/irab163

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Nevin Manimala Statistics

Disparity analysis and prognostic value of pretreatment whole blood Epstein-Barr virus DNA load and EBER status in lymphomas: A retrospective multicenter study in Huaihai Lymphoma Working Group

Int J Cancer. 2021 Sep 14. doi: 10.1002/ijc.33802. Online ahead of print.

ABSTRACT

Elevated Epstein-Barr virus (EBV) DNA load is common in lymphomas. However, it remains unclear whether the disparity in viral load and its prognostic value in lymphomas are correlated with EBER status. In this retrospective multicenter study, we collected the data of pretreatment whole blood EBV DNA (pre-EBV DNA) and EBER status and evaluated their disparity and prognostic values in lymphomas. A total of 454 lymphoma patients from December 2014 to August 2020 were retrospectively retrieved. Mann-Whitney U test, Kruskal-Wallis test, and Bonferroni’s adjustment were used to explore the disparity of EBV DNA and EBER status in lymphomas. Time-dependent receiver operating characteristic analysis and MaxStat analysis were used to determine optimal cut-off points of pre-EBV DNA load. Univariable and multivariable Cox proportional hazards models were established for the estimation of prognostic factors. The positive rate of EBV-DNA in NKTL patients was higher than that in DLBCL, FL, and HL patients, and the median positive pre-EBV copy number of NKTL was also higher than that of FL and DLBCL. EBV-DNA could clearly distinguish the prognosis of DLBCL, NKTL, HL and PTCL, and the integration of EBER status and EBV DNA could differentiate the prognosis of HL patients. Multivariable results revealed that pre-EBV DNA load had an effect on the prognosis of NKTL, FL and DLBCL. The status of pre-EBV DNA and EBER were disparate. Whole blood pre-EBV DNA predicted the prognosis of lymphomas, and the combination of EBV and EBER status could differentiate the prognosis of HL. This article is protected by copyright. All rights reserved.

PMID:34520566 | DOI:10.1002/ijc.33802

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Nevin Manimala Statistics

Three-year Randomized Prospective Clinical Trial of Class II Restorations Using Flowable Bulk-fill Resin Composites

Oper Dent. 2021 Sep 14. doi: 10.2341/20-031-C. Online ahead of print.

ABSTRACT

OBJECTIVES: This randomized, prospective, and split-mouth study aimed to evaluate flowable bulk-fill resin composites in class II restorations and to compare with a conventional layering technique after a 3-year follow-up.

METHODS AND MATERIALS: Fifty-three subjects received three class II restorations according to the restorative systems: conventional microhybrid resin composite (PA, Peak Universal + Amelogen Plus, Ultradent), flowable bulk-fill and nanoparticulate resin composites (ABF, Adper Single Bond 2 + Filtek Bulk Fill Flow + Filtek Z350XT, 3M Oral Care), and flowable bulk-fill and microhybrid resin composites (XST, XP Bond + SDR + TPH3, Dentsply). The clinical performance and interproximal contacts were evaluated. Statistical analyses were performed using the equality test of two proportions, Logistic regression analysis, Friedman, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests (α=0.05).

RESULTS: Forty-seven patients were evaluated at 3 years. XST bulk-fill restorative system presented higher marginal discoloration than PA, and the opposite occurred for surface staining. All restorative systems resulted in decreased interproximal contacts, occurring early for XST.

CONCLUSIONS: Although the restorative system using incremental technique presented better performance for marginal discoloration, one of the restorative systems that used flowable bulk-fill resin composite (XST) showed the lowest surface staining. All restorative systems had decreased proximal contact over time.

PMID:34520538 | DOI:10.2341/20-031-C

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Nevin Manimala Statistics

Evaluating Burn Recovery Outcomes in Children with Neurodevelopmental Symptoms

J Burn Care Res. 2021 Sep 14:irab172. doi: 10.1093/jbcr/irab172. Online ahead of print.

ABSTRACT

Neurodevelopmental symptoms (NS) including attention and behavioral problems, developmental delays, intellectual disabilities and learning problems are prevalent in children with burn injuries. The presence of NS may predispose children to poorer burn injury recovery outcomes compared to children without these symptoms (non-NS). The Multi-Center Benchmarking Study (MCBS) monitored recovery outcomes in children with burn injuries in real time utilizing the Burn Outcomes Questionnaire (BOQ). The objective of this study was to retrospectively assess the long term burn recovery outcomes in NS patients versus non-NS patients from the MCBS population. This study assessed parent-reported BOQ outcomes in a sample of 563 patients aged 5 to 18 years who were admitted for burn injuries to a pediatric burn center. A subsample of patients had reported NS (n=181). Analyses compared BOQ outcomes within the NS subsample and the non-NS subsample (n=382) across three longitudinal points post-discharge. The prevalence rate of NS was 32.1% in the full sample. Findings revealed statistically significant improvement in the recovery curves in all five BOQ subscales for the non-NS group and all subscales except for Compliance for the NS group across all longitudinal points. When compared to non-NS patients, NS patients had significantly poorer burn recovery outcomes on the Satisfaction and Compliance subscales. Although it is important to educate all clinicians, parents, and children on burn prevention efforts, targeted education is necessary for children with NS since they may be at greater risk for burn injury as well as worse recovery outcomes.

PMID:34520544 | DOI:10.1093/jbcr/irab172

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Nevin Manimala Statistics

Effect of the Mini Nutritional Assessment-Short Form (MNA-SF) in Elderly Burn Patients

J Burn Care Res. 2021 Sep 14:irab164. doi: 10.1093/jbcr/irab164. Online ahead of print.

ABSTRACT

OBJECTIVE: Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score.

DESIGN: Prospective observational and cross-sectional study.

METHODS: This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation.

RESULTS: The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF.

CONCLUSION: This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

PMID:34520547 | DOI:10.1093/jbcr/irab164

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A Study of GP Workload and Satisfaction

Ir Med J. 2021 Aug 19;114(7):404.

ABSTRACT

Aims In this novel study in the Irish setting, we quantified the number items managed per General Practitioner (GP) consult, how each item is managed, and impact on a GP’s job satisfaction. Methods Participating GPs at two surgeries completed a questionnaire – integrated into the practice management software – after each consultation that satisfied the inclusion criteria during a four-week period. Results Due to feasibility constraints, 500 of 857 (58.3%) completed questionnaires were randomly selected for our sample. GPs manage an average of 1.76 items per consultation. Older patients presented with more items. Greater number of presenting items led to less being managed on the day 71% (n=5) for 5 items vs. 95.2% (n= 246) for 1 item, longer consultation duration (mean = 14.63 minutes (4-45) and decreased GP satisfaction, mean 8/10 (2-10). Conclusion Increasing the number of items in a GP consultation has a statistically significant effect on duration of consultation, how each item is managed, and even GP satisfaction.

PMID:34520522

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Nevin Manimala Statistics

Response of Aerobic Capacity to Low-Level Laser Therapy in Burned Patients

J Burn Care Res. 2021 Sep 14:irab173. doi: 10.1093/jbcr/irab173. Online ahead of print.

ABSTRACT

BACKGROUND: Severe burns lead to decreased pulmonary function and impaired aerobic capacity for long periods post-injury. Low-level laser therapy is a modality utilized to improve aerobic capacity, enhance exercise performance and increase time until fatigue when utilized before aerobic exercises.

PURPOSE: This work aims to determine the impacts of pre-exercise low-level laser therapy on aerobic capacity in burn cases.

PARTICIPANTS AND METHODS: Sixty adults burned cases of both sexes, aged from 25 to 40 years, with second-degree healed thermal burns, and the total burned body surface area ranged from 20 to 40% participated in this study after complete wound healing. They were randomly categorized into two groups of equal numbers. The study group received low-level laser therapy before aerobic exercises, three sessions/week for 12 weeks, while the control group performed aerobic exercises three times weekly for 12 weeks. All cases received the routine physical treatment program. Aerobic capacity was assessed for both groups by measuring maximum oxygen consumption and time to exhaustion at baseline and twelve weeks following interventions.

FINDINGS: There was a statistically significant rise in the mean values of maximum oxygen usage and time to fatigue after 12 weeks of treatment in both groups. However, after comparison, the improvements in the study group were statistically significant than those in the control group with (p < 0.01), (p < 0.05) respectively.

CONCLUSION: Low-level laser therapy has a beneficial therapeutic impact on promoting aerobic capacity, improving maximum oxygen consumption, and increasing treadmill time in burned cases when preceding aerobic exercises.

PMID:34520536 | DOI:10.1093/jbcr/irab173

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Nevin Manimala Statistics

Does postoperative quantitative bone scintigraphy reflect outcomes following medial open-wedge high tibial osteotomy?

PLoS One. 2021 Sep 14;16(9):e0257315. doi: 10.1371/journal.pone.0257315. eCollection 2021.

ABSTRACT

PURPOSE: The present study evaluated changes in bone tracer uptake (BTU) after medial open-wedge high tibial osteotomy (MOWHTO) and determined whether postoperative BTU correlates with clinical symptoms, radiologic parameters, or cartilage regeneration following MOWHTO.

METHODS: A total of 210 knees underwent MOWHTO for medial compartmental osteoarthritis (OA) were enrolled in this study. Mean follow-up period was 42.7 months. We assessed BTU for the medial compartment of the knee before MOWHTO and at the time of plate removal. Radiologic parameters included Kellgren-Lawrence (K-L) grade and Hip-Knee-Ankle angle (HKAA). Clinical evaluation included American Knee Society (AKS) score and cartilage status was graded at the time of MOWHTO and second-look arthroscopy according to the International Cartilage Repair Society (ICRS) grading system and articular cartilage regeneration stage. Statistical analysis performed to assess the relationships among postoperative BTU of the medial compartment, radiologic parameters, arthroscopic changes and clinical outcomes.

RESULTS: BTU of medial femoral condyle and tibial plateau were significantly decreased at 2 years after MOWHTO (p<0.001). AKS scores and arthroscopic cartilage status were also significantly improved following MOWHTO. BMI and postoperative HKAA showed significant correlations with postoperative changes of BTU in uni- and multi-variable analysis. Meanwhile, postoperative changes of BTU did not show significant correlation with clinical outcomes or cartilage regeneration following MOWHTO.

CONCLUSION: Lower BMI and postoperative valgus alignment were significant predictor for postoperative BTU decrease of the medial compartment following MOWHTO. However, postoperative changes of BTU did not reflect cartilage regeneration or clinical outcomes until the midterm follow-up.

PMID:34520482 | DOI:10.1371/journal.pone.0257315

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Histologic Findings and Tissue B-Cell Depletion in Endoscopic Mucosal Biopsy Specimens of the Gastrointestinal Tract After Treatment With Rituximab

Am J Clin Pathol. 2021 Sep 14:aqab133. doi: 10.1093/ajcp/aqab133. Online ahead of print.

ABSTRACT

OBJECTIVES: Rituximab (RTX) is associated with variable adverse gastrointestinal (GI) events. However, the histologic correlate in affected patients is not well defined.

METHODS: Patients (n = 93) who had received RTX and undergone endoscopic biopsies were identified. CD20 and PAX5 immunostains were performed on biopsy specimens showing inflammatory pathology (group A, 36 patients) and 35 of 57 noninflammatory biopsies (group B) that were taken within 1 year from the last RTX infusion. Histologic findings were correlated with tissue B-cell depletion (CD20/PAX5-/-).

RESULTS: B cells were depleted in 12 (33%) of 36 group A biopsy specimens. After excluding biopsies taken more than 1 year from the last RTX infusion, the frequencies of tissue B-cell depletion were similar between group A (12/26; 46.2%) and group B (17/35; 48.6%) (P > .05). Also, the frequencies of inflammatory pathology were not statistically different whether B cells were depleted or not (P > .05). In group A with tissue B-cell depletion (n = 12), causality was indicated in two (17%) cases showing lymphocytic colitis pattern of injury (LCPI).

CONCLUSIONS: In RTX-treated patients, tissue B-cell depletion does not appear to be the main cause of inflammatory pathology in the GI tract. A minor subset, however, develops histologic evidence of potential RTX-induced effect, notably in the form of LCPI.

PMID:34520518 | DOI:10.1093/ajcp/aqab133

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Lack of effect on in-hospital mortality of drugs used during COVID-19 pandemic: Findings of the retrospective multicenter COVOCA study

PLoS One. 2021 Sep 14;16(9):e0256903. doi: 10.1371/journal.pone.0256903. eCollection 2021.

ABSTRACT

INTRODUCTION: During COVID-19 pandemic, the use of several drugs has represented the worldwide clinical practice. However, though the current increase of knowledge about the disease, there is still no effective treatment for the usage of drugs. Thus, we retrospectively assessed use and effects of therapeutic regimens in hospitalized patients on in-hospital mortality.

METHODS: COVOCA is a retrospective observational cohort study on 18 COVID centres throughout Campania Region Hospitals. We included adult patients with confirmed SARS-CoV-2 infection, discharged/dead between March/June 2020.

RESULTS: 618 patients were included, with an overall in-hospital cumulative mortality incidence of 23.1%. Most prescribed early treatments were antivirals (72%), antibiotics (65%) and hydroxychloroquine/anticoagulants (≈50%). Tocilizumab, indeed, was largely prescribed late during hospitalization. Multivariable models, with a cut-off at day 2 for early COVID-19 therapy administration, did not disclose any significant association of a single drug administration on the clinical outcome.

DISCUSSION: COVOCA represents the first multicenter database in Campania region. None drug class used during the pandemic significantly modified the outcome, regardless of therapy beginning, both overall and net of those already in non-invasive ventilation (NIV)/ orotracheal intubation (OTI) at hospitalization. Our cumulative incidence of mortality seems lower than other described during the same period, particularly in Northern Italy.

PMID:34520465 | DOI:10.1371/journal.pone.0256903