Tag: pubmed

Egypt J Immunol. 2022 Oct;29(4):94-105.

ABSTRACT

Psoriasis is a chronic debilitating skin disease with an estimated prevalence reaching 2% of the worldwide population. Psoriatic disease is driven by the interactions among innate and adaptive immune systems with structural components of the skin. Interleukin (IL)-22 mediates keratinocyte proliferation and epidermal hyperplasia, and changes in the structure of skin flora can play a role in the secretion of IL-22. The aim of this study was to correlate serum levels of IL-22 and Staphylococcus aureus toxins with disease activity in plaque psoriasis. The study group included 50 patients with mild, moderate, and severe psoriasis. The control group comprised 20 sex- and age-matched apparently healthy volunteers. IL-22 concentration was assessed in sera of patients and the control group by using the ELISA technique. The serum levels of IL-22 in patients were higher than in the control group, but the difference was statistically insignificant (P=0.413). Serum IL-22 levels were positively correlated with the Psoriasis Area and Severity Index (PASI) score of psoriasis patients (P=0.0003). The IL-22 serum levels in patients colonized with toxigenic strains of S. aureus were significantly higher than in patients colonized with non-toxigenic strains (P= 0.028). In conclusion, IL-22 plays a role in the pathogenesis of psoriasis, and its secretion can be triggered by the toxins produced by S. aureus colonizing the skin of patients.

PMID:36198107

Clin J Pain. 2022 Oct 3. doi: 10.1097/AJP.0000000000001076. Online ahead of print.

ABSTRACT

OBJECTIVES: People living with chronic pain may use wearable health technology (WHT) in conjunction with an expert-directed pain management program for up to one year. WHT use may be associated with improvements in key patient outcomes.

METHODS: A 12-month study of WHT use among people with chronic pain was conducted, consisting of iPhone and Apple Watch applications to measure movement, sleep, and self-reported pain. Clinical outcomes among 105 patients enrolled in a multidisciplinary pain program that included WHT use were compared to 146 patients in the same program but without WHT, and to 161 patients receiving medical pain management without WHT.

RESULTS: Participants used the WHT on average 143.0 (SD 117.6) out of 365 days. Mixed-effects models revealed participants who used WHT had decreases in depression scores (-7.83, P<0.01) and prescribed morphine milligram equivalents (-21.55, P=0.04) over one year. Control groups also showed decreases in depression scores (-5.08, P=0.01; -5.68, P<0.01) and morphine milligram equivalents (-18.67, P=0.01; -10.99, ns). The estimated slope of change among the WHT was not statistically different than control groups.

DISCUSSION: Patients who used WHT as part of their pain management program demonstrated a willingness to do so for extended periods of time despite living with chronic pain and other comorbidities. Data trends suggest that WHT use may positively impact depression and prescribed medication. Additional research is warranted to investigate the potential of WHT to improve the negative consequences of chronic pain.

PMID:36198095 | DOI:10.1097/AJP.0000000000001076

Echocardiography. 2022 Oct 5. doi: 10.1111/echo.15445. Online ahead of print.

ABSTRACT

BACKGROUND: Coronary vasomotion abnormalities have been described in small studies but not studied systematically. We aimed to review the present literature and analyze it to improve our understanding of chronic kidney disease (CKD) related-coronary microvascular dysfunction.

OBJECTIVE: Coronary flow reserve (CFR) is a well-known measure of coronary vasomotion. We aimed to assess the difference in CFR among participants with and without CKD.

METHODS: PubMed, Embase, and Cochrane CENTRAL were systematically reviewed to identify studies that compared CFR in participants with and without CKD. We estimated standardized mean differences in mean CFR reported in these studies. We performed subgroup analyses according to imaging modality, and the presence of significant epicardial coronary artery disease.

RESULTS: In 14 observational studies with 5966 and 1410 patients with and without CKD, the mean estimated glomerular filtration rate (eGFR) was 29 ± 04 and 87 ± 25 ml/min/1.73 m² , respectively. Mean CFR was consistently lower in patients with CKD in all studies and the cumulative mean difference was statistically significant (2.1 ± .3 vs. 2.7 ± .5, standardized mean difference -.8, 95% CI -1.1, -.6, p < .05). The lower mean CFR was driven by both significantly higher mean resting flow velocity (.58 cm/s, 95% CI .17, .98) and lower mean stress flow velocity (-.94 cm/s, 95% CI -1.75, -.13) in studies with CKD. This difference remained significant across diagnostic modalities and even in absence of epicardial coronary artery disease. In meta-regression, there was a significant positive relationship between mean eGFR and mean CFR (p < .05).

CONCLUSION: Patients with CKD have a significantly lower CFR versus those without CKD, even in absence of epicardial coronary artery disease. There is a linear association between eGFR and CFR. Future studies are required to understand the mechanisms and therapeutic implications of these findings.

KEY POINTS: In this meta-analysis of observational studies, there was a significant reduction in coronary flow reserve in studies with chronic kidney disease versus those without. This difference was seen even in absence of epicardial coronary artery disease. In meta-regression, a lower estimate glomerular filtration rate was a significant predictor of lower coronary flow reserve. Coronary microvascular dysfunction, rather than atherosclerosis-related epicardial disease may underly increase cardiovascular risk in a patient with chronic kidney disease.

PMID:36198077 | DOI:10.1111/echo.15445

J Speech Lang Hear Res. 2022 Oct 5:1-11. doi: 10.1044/2022_JSLHR-22-00157. Online ahead of print.

ABSTRACT

OBJECTIVE: Currently, no clinically feasible objective measures exist that are specific to the signs of adductor laryngeal dystonia (LD), deterring effective diagnosis and treatment. This project sought to establish concurrent validity of a new automated acoustic outcome measure, designed to be specific to adductor laryngeal dystonia (AdLD): the spectral aggregate of the high-passed fundamental frequency contour (SAHf _o).

METHOD: Twenty speakers with AdLD read voiced phoneme-loaded (more symptomatic) and voiceless phoneme-loaded (less symptomatic) sentences. LD discontinuities (defined as phonatory breaks, frequency shifts, and creak), the acoustic ramifications of laryngeal spasms, were manually identified. The frequency content of the f _o contour was examined as a function of time, and content above 1000 Hz was summed to automatically calculate SAHf _o. Multiple linear regression analysis was applied to SAHf _o based on LD discontinuities and sentence type (voiced or voiceless phoneme-loaded).

RESULTS: The regression model accounted for 41.1% of the variance in SAHf _o. Both the LD discontinuities and sentence type were statistically related to SAHf _o.

CONCLUSION: Results of this study provide evidence of concurrent validity. SAHf _o is an automatic outcome measure specific to acoustic signs of AdLD that may be useful to track treatment progress.

PMID:36198059 | DOI:10.1044/2022_JSLHR-22-00157

J Clin Psychiatry. 2022 Oct 3;83(6):22m14447. doi: 10.4088/JCP.22m14447.

ABSTRACT

Objective: Determine if sublingual dexmedetomidine, a selective α₂ adrenergic receptor agonist, reduces symptoms of acute agitation associated with schizophrenia or schizoaffective disorder.

Methods: This phase 3, randomized, double-blind, placebo-controlled study was conducted in adults diagnosed with schizophrenia or schizoaffective disorder per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The study was conducted at 15 US sites between January 23, 2020, and May 8, 2020. Participants were randomized to sublingual dexmedetomidine 180 μg, 120 μg, or matching placebo. The primary efficacy endpoint was mean change from baseline in the Positive and Negative Syndrome Scale-Excited Component (PEC) total score at 2 hours postdose.

Results: Altogether, 380 participants (mean age 45.6 years, 63.4% identifying as male, 77.9% identifying as Black or African American) were randomized; 380 (100%) self-administered study medication, and 372 (97.9%) completed the study. The mean PEC total score at baseline (17.6) indicated mild to moderate agitation. At 2 hours postdose, the least squares mean changes (SE) from baseline were -10.3 (0.4) for sublingual dexmedetomidine 180 μg, -8.5 (0.4) for 120 μg, and -4.8 (0.4) for placebo. Least squares mean differences (97.5% confidence intervals) in the sublingual dexmedetomidine groups were -5.5 (-6.7 to -4.3) for 180 μg and -3.7 (-4.9 to -2.5) for 120 μg (both P < .001 vs placebo). The most commonly encountered adverse events with dexmedetomidine (incidence ≥ 5% and ≥ 2× rate observed with placebo) were somnolence, dry mouth, and hypotension for the 120 μg dose, and somnolence, dizziness, orthostatic hypotension, and oral hypoesthesia for the 180 μg dose.

Conclusions: Treatment with sublingual dexmedetomidine 180 μg or 120 μg was more efficacious than placebo in reducing acute agitation associated with schizophrenia as measured by PEC scores at 2 hours postdose.

Trial Registration: ClinicalTrials.gov identifier: NCT04268303.

PMID:36198061 | DOI:10.4088/JCP.22m14447

J Speech Lang Hear Res. 2022 Oct 5:1-11. doi: 10.1044/2022_JSLHR-22-00136. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated whether listener processing of dysarthric speech requires the recruitment of more cognitive resources (i.e., higher levels of listening effort) than neurotypical speech. We also explored relationships between behavioral listening effort, perceived listening effort, and objective measures of word transcription accuracy.

METHOD: A word recall paradigm was used to index behavioral listening effort. The primary task involved word transcription, whereas a memory task involved recalling words from previous sentences. Nineteen listeners completed the paradigm twice, once while transcribing dysarthric speech and once while transcribing neurotypical speech. Perceived listening effort was rated using a visual analog scale.

RESULTS: Results revealed significant effects of dysarthria on the likelihood of correct word recall, indicating that the transcription of dysarthric speech required higher levels of behavioral listening effort relative to neurotypical speech. There was also a significant relationship between transcription accuracy and measures of behavioral listening effort, such that listeners who were more accurate in understanding dysarthric speech exhibited smaller changes in word recall when listening to dysarthria. The subjective measure of perceived listening effort did not have a statistically significant correlation with measures of behavioral listening effort or transcription accuracy.

CONCLUSIONS: Results suggest that cognitive resources, particularly listeners’ working memory capacity, are more taxed when deciphering dysarthric versus neurotypical speech. An increased demand on these resources may affect a listener’s ability to remember aspects of their conversations with people with dysarthria, even when the speaker is fully intelligible.

PMID:36198057 | DOI:10.1044/2022_JSLHR-22-00136

J Am Vet Med Assoc. 2022 Oct 4:1-7. doi: 10.2460/javma.22.08.0367. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of the cyclooxygenase-2-selective NSAID firocoxib, compared to the nonselective NSAID flunixin meglumine on viscoelastic coagulation parameters in healthy horses.

ANIMALS: 12 healthy adult mixed-breed horses.

PROCEDURES: Following a crossover protocol, horses were administered flunixin meglumine (1.1 mg/kg, IV, q 12 h for 5 days), allowed a 6-month washout period, and then administered firocoxib (0.3 mg/kg, PO, once, then 0.1 mg/kg, PO, q 24 h for 4 days). Omeprazole (1 mg/kg, PO, q 24 h) was administered concurrently with each NSAID. Viscoelastic coagulation profiles and traditional coagulation parameters (prothrombin time, partial thromboplastin time, and fibrinogen) were measured before and after each treatment.

RESULTS: Viscoelastic coagulation parameters were within reference intervals before and after both treatments. There was a statistically significant difference between treatments for amplitude at 10 minutes after clot time (P = .02) and maximum clot formation (P = .02); however, the magnitude of change was not clinically significant.

CLINICAL RELEVANCE: Short-term administration of flunixin meglumine and firocoxib did not result in significant alteration of viscoelastic coagulation profiles in healthy horses. However, clinicians should be aware of possible coagulopathy secondary to NSAID administration with long-term use or critical illness, and further study is indicated.

PMID:36198050 | DOI:10.2460/javma.22.08.0367

Nutr Health. 2022 Oct 5:2601060221130424. doi: 10.1177/02601060221130424. Online ahead of print.

ABSTRACT

Purpose: This study aimed to evaluate the acute changes in retinal vasculature following coffee consumption. Methods: This is an interventional case series. The subjects were 22 healthy young adults. They were asked to rest in a silent room for 15 min; then, their heart rate, blood pressure, and arterial oxygen saturation pressure were measured with a single patient monitoring system. Optical coherence tomography (OCT) and OCT angiography (OCT-A) imaging of the disc and macula were performed for both eyes of the subjects. These measurements were repeated 45 min after drinking a cup of 450 ml of coffee containing a standard dose of 130 mg of caffeine. Macular and optic nerve head neurovasculature changes were assessed. Results: The results of our study did not show a significant change in peripapillary retinal nerve fiber layer thickness and neural structural and vascular parameters of the optic nerve head. Although assessments of macular vasculature showed a significant decrement in superficial (p = 0.01) and deep vessel density (p = 0.05) at parafovea, vessel densities (VDs) at the fovea, and deep capillary plexus at perifovea showed no significant change. Conclusion: Consuming one cup of coffee (150 mg caffeine) statistically changes central foveal thickness and parafoveal blood flow but likely does not have a clinical impact in healthy young adults.

PMID:36198039 | DOI:10.1177/02601060221130424

Nutr Health. 2022 Oct 5:2601060221129695. doi: 10.1177/02601060221129695. Online ahead of print.

ABSTRACT

BACKGROUND: Anaemia is a serious global public health problem with high prevalence (>40%) in children particularly in low- and middle-income countries including Namibia with a current 46.1% prevalence rate.

AIM: This study was aimed at examining the sociodemographic factors influencing the occurrence of childhood anaemia levels in Namibia.

METHOD: A multivariate ordinal regression model was applied to statistically identify potential sociodemographic factors associated with anaemia levels among children under-5 years old using data collected from the 2013 NDHS.

RESULTS: The odds of having mild anaemia level was lower for sociodemographic characteristics such as mother’s age, total children ever born, health insurance coverage, child’s residency, child’s age and main language spoken at home. The odds of having moderate anaemia level was higher for characteristics such as mother’s age, place of residence, highest education level and child’s diarrhoea status, while it was lower for characteristics such as age of head of household, total children ever born, health insurance coverage and sex of child. Similarly, the odds of having severe anaemia level was higher for characteristics such as region, place of residence, highest education level, number of household members, wealth index, health insurance coverage, child’s residency and child’s diarrhoea status, while it was lower for characteristics such as total children ever born and sex of child.

CONCLUSION: It is therefore recommended that the policies and practices concerning anaemia diagnosis, treatment and prevention in the country be substantially revised by policy-makers, starting with the known prevalent causes and identified sociodemographic factors from this study.

PMID:36198037 | DOI:10.1177/02601060221129695

Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221130063. doi: 10.1177/10760296221130063.

ABSTRACT

BACKGROUND: Percutaneous coronary intervention (PCI) is the main treatment option for acute coronary syndromes (ACS) often related to the progression and rupture of vulnerable plaques. While drug-eluting stents (DES) are now routinely used in PCI, drug-coated balloons (DCB) are a new strategy to PCI and their practice in the treatment of ACS with vulnerable plaques has not been reported. This study aimed to evaluate the safety and efficacy of DCB in ACS complicated with vulnerable plaque lesions.

METHODS: 123 patients were retrospectively analyzed and diagnosed with ACS and given PCI in our Cardiology Department from December 2020 to July 2022. Vulnerable plaques were confirmed by intravenous ultrasound (IVUS) in all patients. According to individual treatment plan, patients were entered into either DCB (n = 55) or DES (n = 68) groups. The results of coronary angiography and IVUS before and immediately after percutaneous coronary intervention were analyzed. The occurrence of major adverse cardiovascular events (MACE) and the results of coronary angiography were also evaluated during follow-up.

RESULTS: There were no significant differences in baseline clinical characteristics, preoperative minimal luminal diameter (MLD), and preoperative diameter stenosis (DS) between the two groups. Also, there were no differences in IVUS plaque burden (PB), vessel area, and lumen area in the two groups before and immediately after PCI. The efficacy analysis showed that immediately after PCI, the DCB group had smaller MLD and higher degrees of lumen stenosis than the DES group (P < 0.05). However, during follow-up, no significant differences in MLD and DS were seen in two groups; relatively, late loss in luminal diameter（LLL）in the DCB group was smaller (P＜0.05). Safety analysis showed that during follow-up, 9 patients developed restenosis after DCB implantation while restenosis occurred in 10 patients with DES treatment, no statistical difference in the incidence of restenosis in the two groups. Besides, there was no statistical difference in the incidence of major adverse cardiac events（MACE）during hospitalization and follow-up in the DCB group (7.3% (4/55)) and the DES group (8.8% (6/68)).

CONCLUSION: DCB is safe and effective for ACS complicated with vulnerable plaque and has an advantage over DES in LLL.

PMID:36198017 | DOI:10.1177/10760296221130063