Tag: pubmed

Arch Oral Biol. 2021 Mar 23;125:105112. doi: 10.1016/j.archoralbio.2021.105112. Online ahead of print.

ABSTRACT

OBJECTIVES: Talon cusp is a developmental anomaly consisting of a vertical ridge or cusp projecting labially or lingually from an anterior permanent or primary tooth. A range of prevalence between 0.06 % and 40.8 % has been reported in the literature. Although many epidemiological studies have been conducted, no synthesis of these data has been performed to date. The aim of this paper was to determine the prevalence of talon cusp and to investigate the link between sex and talon cusp.

SOURCE: A systematic search was undertaken using the PubMed/Medline, Embase and Cochrane Library electronic databases for publications from 1981 to 2020 investigating the prevalence of talon cusp and the link between talon cusp and sex.

STUDY SELECTION: Three reviewers selected the studies independently, extracted the data in accordance with the PRISMA statement, and assessed the risk of bias via the GRADE & Cochrane approaches.

RESULTS: From 39 potentially eligible studies, 9 were selected for full text analysis and 8 were included in the meta-analysis, representing 35,224 participants. The meta-analyses were performed with a random model, calculating a weighted-mean prevalence (at least one talon cusp per individual) of 1.67 %. Sex and talon cusp were not statistically significantly associated in our study (OR = 1.10; 95 % CI [0.82-1.47]; p > 0.05).

DISCUSSION: We report the first prevalence of talon cusp provided by meta-analysis in a non-syndromic sample. A non-statistically significant association between sex and talon cusp is relevant in terms of genetic etiology. In order to improve the homogeneity and accuracy of the results of further studies, we propose a new universal scoring system for talon cusp.

CLINICAL SIGNIFICANCE: Talon cusp is a developmental anomaly with various clinical implications. Therapeutics may vary from simple monitoring to extraction of the supporting tooth. This condition occurs in approximately 1.67 % of the population.

PMID:33780721 | DOI:10.1016/j.archoralbio.2021.105112

S Afr J Surg. 2021 Mar;59(1):2-6.

ABSTRACT

BACKGROUND: Approximately 25% of patients with colorectal cancer (CRC) will be diagnosed with CRC liver metastases (CRCLM) during the course of their disease. No data regarding CRCLM presentation, management and survival outcomes has been published from either the private or public health care sectors in South Africa. This study aimed to address this deficit, reporting on a private sector cohort.

METHODS: A retrospective review of a private health care funder’s database from 1 January 2008 to 31 December 2015 was performed. ICD-10 diagnosis codes were used to identify CRC and CRCLM. Procedure codes assigned to hospital admissions were used to identify the type of surgical treatment. Chemotherapy was identified by the WHO Anatomical Therapeutic Chemical classification system of medicines. Treatment patterns were assessed and five-year overall survival (OS) was calculated. Survival was estimated using the Kaplan-Meier method, and Cox proportional-hazards regression was used for between group survival comparisons.

RESULTS: Six hundred and one (601) of 3 412 patients presenting with CRC (17.6%) were diagnosed with CRCLM at presentation or during the follow-up period. Sixty patients with CRCLM (10.0%) underwent resection of the primary CRC and liver resection for metastases, 281 (46.8%) underwent CRC resection only, 180 (30%) received chemotherapy only, and 47 (7.8%) received no treatment. Five-year OS for these groups were 57.3%, 15.6%, 9.8% and 0% respectively.

CONCLUSION: Five-year OS of the various CRCLM treatment pathways in a South African private sector population compares to results published in international series. However, a smaller proportion of patients with CRCLM underwent liver resection, compared to international studies.

PMID:33779097

S Afr J Surg. 2021 Mar;59(1):7-11.

ABSTRACT

BACKGROUND: The spectrum of male breast disease (MBD) and its relative proportions is not well documented. This study aims to describe the demographics, clinical, radiological and histopathological characteristics of the spectrum of MBD managed at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).

METHODS: This is a retrospective, descriptive study of all male patients diagnosed with MBD at CMJAH between 1 January 2016 and 31 December 2018. Patients’ data were extracted from the Breast Imaging Department, CMJAH Breast Clinic and the National Health Laboratory Services patients’ records. Data collected included patients’ demographics, clinical presentation, radiological findings and histopathological diagnosis, where available. The collected data were captured using REDCap™ and were analysed using Statistica 13 and SAS version 9.2. P-value of 0.05 was used for statistical significance.

RESULTS: Of the 269 males imaged, 244 (91%) had a diagnosed breast condition, 90% of which were benign. Gynaecomastia accounted for 85% of all breast disease diagnosed. Patients who presented with benign breast disease were significantly younger than those with malignant breast disease, with a mean age of 45.59 years vs 58.29 years (p = 0.0007). Seventyone per cent of patients had a known HIV status with 39% being HIV positive. There was a significant association between patients with HIV and benign breast disease (p = 0.0129).

CONCLUSION: Gynaecomastia is the most common MBD seen at CMJAH. There was a significant association between HIV and benign breast disease. This association should be explored further with respect to the direct effects of the virus and to those of the antiretroviral medication.

PMID:33779098

Yonsei Med J. 2021 Apr;62(4):288-297. doi: 10.3349/ymj.2021.62.4.288.

ABSTRACT

PURPOSE: Natural killer (NK) cells are innate immune cells with antitumor activity. NKG2D is the most important activating receptor expressed on the NK cell surface; this receptor binds to the ligands MICA/B and ULBPs to activate NK cells. The current study aimed to evaluate the expression of NKG2D by NK cells, and to the evaluate expression of its ligands in ovarian carcinomas; it also examined the clinical relevance of NK receptor/ligand expression by analyzing the relationship between expression, clinicopathological parameters, and prognosis.

MATERIALS AND METHODS: Formalin-fixed paraffin-embedded archival ovarian high-grade serous carcinoma (HGSC, n=79) tissue samples were used for tissue microarray analysis. The expressions of NK cell markers (CD56 and NKG2D) and NKG2D ligands (MICA/B, ULBP1, ULBP3, and ULBP2/5/6) in carcinoma tissues were evaluated by immunohistochemical staining, and the association between these results and clinical prognostic parameters was analyzed statistically.

RESULTS: ULBP1 was highly expressed in 51 cases (64.6%), and ULBP2/5/6 was highly expressed in 56 cases (70.9%) of HGSC. High expression of ULBP1 and ULBP2/5/6 was significantly associated with lower recurrence of HGSC, whereas high expression of ULBP3 was significantly associated with higher recurrence. Multivariate Cox regression analysis revealed that high expression of ULBP1 was associated with increased overall survival and a decreased hazard ratio (0.150, p=0.044), suggesting that it is an independent predictor of better survival.

CONCLUSION: High expression of ULBP1 predicts a better prognosis for HGSC, suggesting that ULBP1 expression could be a novel prognostic indicator in this subset of carcinomas.

PMID:33779082 | DOI:10.3349/ymj.2021.62.4.288

Yonsei Med J. 2021 Apr;62(4):344-351. doi: 10.3349/ymj.2021.62.4.344.

ABSTRACT

PURPOSE: Metabolic syndrome (MetS) comprises a cluster of risk factors for future cardiovascular and metabolic diseases. Only a few recent studies have reported the trend in the prevalence of MetS in youth. This study aimed to analyze trends in the prevalence of MetS and nutrient intake in the last 10 years and investigate the changes in MetS components among Korean children and adolescents.

MATERIALS AND METHODS: We analyzed the data of 9513 children and adolescents aged 10-19 years from the 2008-2017 Korean National Health and Nutrition Examination Surveys. Diagnosis of MetS was based on the International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria.

RESULTS: Based on the IDF criteria, MetS prevalence increased from 1.53% in 2008 to 3.19% in 2017 (p=0.007). Based on the NCEP-ATP III criteria, MetS prevalence increased from 2.18% in 2008 to 3.19% in 2017; however, the increase was not statistically significant. Daily calorie and fat intakes increased significantly during the study period. Among the risk factors that MetS comprises, the prevalence rates of central obesity, low high-density lipoprotein cholesterol levels, and high fasting glucose levels increased significantly.

CONCLUSION: Over the last 10 years, the prevalence of MetS has grown significantly with increasing calorie and fat intake in Korean children and adolescents. Central obesity and high-density lipoprotein cholesterol and fasting glucose levels have worsened. Therefore, active support and close monitoring are required to control MetS and prevent further increase in the prevalence of cardiovascular diseases.

PMID:33779088 | DOI:10.3349/ymj.2021.62.4.344

Yonsei Med J. 2021 Apr;62(4):366-369. doi: 10.3349/ymj.2021.62.4.366.

ABSTRACT

The purpose of the current study was to compare prognostic outcomes between patients with high-grade ovarian Sertoli-Leydig cell tumors (SLCTs) and those with other low-grade SLCTs. We retrospectively reviewed medical records for 24 patients pathologically diagnosed with SLCTs between 2006 to 2019 at two institutions. The patients were grouped according to pathological grade: SLCT was classified as grade 1, well differentiated; grade 2, intermediated differentiated; or grade 3, poorly differentiated (Meyer’s classification). Statistical analysis was performed to compare survival outcomes according to pathological grade. The median patient age was 42.5 years (range 16-75). Eighteen patients (75%) were International Federation of Gynecology and Obstetrics stage I, and none were diagnosed in stage IV. Nine patients (37.5%) were grade 3, and 15 patients (63.5%) were grades 1-2. When comparing clinical baseline characteristics of the grade 1-2 group with those of the grade 3 group, only serum CA125 level at diagnosis was significantly higher in the grade 3 group (38.34 vs. 382.29, p=0.002). Five patients experienced recurrence of grade 3 disease, while no recurrence was reported in grade 1-2 disease. Four of the five recurrent patients died. In result, grade 3 ovarian SLCT showed significantly poorer prognosis than grade 1-2 disease (overall survival, hazard ratio=14.25, 95% confidence interval=1.881-108.0; log-rank p=0.010). Our findings were consistent with the concept that patients with stage I/grade 1-2 tumors have a good prognosis without adjuvant chemotherapy. Since grade 3 ovarian SLCT appears to be relatively more fatal than grade 1 or 2, patients with grade 3 SLCT might require more aggressive surgical intervention and post-treatment surveillance.

PMID:33779091 | DOI:10.3349/ymj.2021.62.4.366

ESC Heart Fail. 2021 Mar 28. doi: 10.1002/ehf2.13320. Online ahead of print.

ABSTRACT

AIMS: There is a critical need for better biomarkers so that heart failure can be diagnosed at an earlier stage and with greater accuracy. The purpose of this study was to design a robust mass spectrometry (MS)-based assay for the simultaneous measurement of a panel of 35 candidate protein biomarkers of heart failure, in blood. The overall aim was to evaluate the potential clinical utility of this biomarker panel for prediction of heart failure in a cohort of 500 patients.

METHODS AND RESULTS: Multiple reaction monitoring (MRM) MS assays were designed with Skyline and Spectrum Mill PeptideSelector software and developed using nanoflow reverse phase C18 chromatographic Chip Cube-based separation, coupled to a 6460 triple quadrupole mass spectrometer. Optimized MRM assays were applied, in a sample-blinded manner, to serum samples from a cohort of 500 patients with heart failure and non-heart failure (non-HF) controls who had cardiovascular risk factors. Both heart failure with reduced ejection fraction (HFrEF) patients and heart failure with preserved ejection fraction (HFpEF) patients were included in the study. Peptides for the Apolipoprotein AI (APOA1) protein were the most significantly differentially expressed between non-HF and heart failure patients (P = 0.013 and P = 0.046). Four proteins were significantly differentially expressed between non-HF and the specific subtypes of HF (HFrEF and HFpEF); Leucine-rich-alpha-2-glycoprotein (LRG1, P < 0.001), zinc-alpha-2-glycoprotein (P = 0.005), serum paraoxanse/arylesterase (P = 0.013), and APOA1 (P = 0.038). A statistical model found that combined measurements of the candidate biomarkers in addition to BNP were capable of correctly predicting heart failure with 83.17% accuracy and an area under the curve (AUC) of 0.90. This was a notable improvement on predictive capacity of BNP measurements alone, which achieved 77.1% accuracy and an AUC of 0.86 (P = 0.005). The protein peptides for LRG1, which contributed most significantly to model performance, were significantly associated with future new onset HF in the non-HF cohort [Peptide 1: odds ratio (OR) 2.345 95% confidence interval (CI) (1.456-3.775) P = 0.000; peptide 2: OR 2.264 95% CI (1.422-3.605), P = 0.001].

CONCLUSIONS: This study has highlighted a number of promising candidate biomarkers for (i) diagnosis of heart failure and subtypes of heart failure and (ii) prediction of future new onset heart failure in patients with cardiovascular risk factors. Furthermore, this study demonstrates that multiplexed measurement of a combined biomarker signature that includes BNP is a more accurate predictor of heart failure than BNP alone.

PMID:33779078 | DOI:10.1002/ehf2.13320

Australas J Ageing. 2021 Mar 28. doi: 10.1111/ajag.12941. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe the patterns of personal emergency response systems (PERS) use in a statewide cohort of older Australians.

METHODS: PERS data from clients enrolled in the Personal Alarm Victoria program between January 2014 and June 2017 were analysed. Alarm activation reasons were extracted, and a medical record audit was performed for a sub-cohort of patients admitted to a local hospital following an alarm event. Descriptive statistics were used.

RESULTS: There were 42,180 clients enrolled during the study (mean age 80 years, 80% female, 93% living alone). An ambulance attended 44% of the fall-related events and 81% of events coded as unwell. Activation reasons were distributed equally between a fall and feeling unwell, and a repeating pattern of activation reasons was observed. In our sub-cohort (n = 92), the majority of admissions (86%) followed an alarm activation coded as unwell.

CONCLUSION: We demonstrated recurring patterns associated with the reasons for alarm use.

PMID:33779038 | DOI:10.1111/ajag.12941

J Med Imaging Radiat Oncol. 2021 Mar 28. doi: 10.1111/1754-9485.13176. Online ahead of print.

ABSTRACT

INTRODUCTION: Lower gastrointestinal haemorrhage (LGIH) is a challenging phenomenon in a comorbid, elderly population. CT mesenteric angiography (CTMA) allows localisation of the site of haemorrhage, and provides a target for interventional techniques, but the intermittent nature of LGIH makes it challenging to reliably demonstrate extravasation. This study aimed to identify objective factors that may predict scan outcomes.

METHODS: In this retrospective cohort study, all patients undergoing CTMA for LGIH at Monash Health from January 2011 to December 2019 (n = 854) were included. Baseline patient characteristics included age, bowel resection/endoscopic intervention within the past 14 days, known bowel malignancy, anticoagulant/antiplatelet use, duration of symptoms, vital signs, transfusion requirements in the past 24 h and investigation results (recent haemoglobin levels, platelet count, international normalised ratio and creatinine levels). Univariate analysis was performed, and significant factors were entered into a multivariate model.

RESULTS: The final multivariate model was statistically significant (P < 0.001) and consisted of bowel resection/endoscopic intervention within the past 14 days (OR = 2.15), use of antiplatelet agents (OR = 2.03), blood transfusion requirement greater than 3 units per 24 h (OR = 1.79), systolic blood pressure less than 100 mmHg (OR = 1.56) and heart rate greater than 100 beats per minute (OR = 1.52).

CONCLUSION: The factors identified above are objective, independently associated with positive scan outcomes, readily available to radiologists and are useful for more judicious patient selection.

PMID:33779045 | DOI:10.1111/1754-9485.13176

Cancer Med. 2021 Mar 28. doi: 10.1002/cam4.3835. Online ahead of print.

ABSTRACT

INTRODUCTION: In surgical series of muscle-invasive bladder cancer (MIBC), women have higher recurrence rates, disease progression, and mortality following radical cystectomy than men. Similar reports of oncologic differences between men and women following trimodality therapy (TMT) are rare. Our hypothesis was that there would be no difference in overall survival (OS) between sexes receiving TMT.

METHODS: We queried the National Cancer Database (NCDB) for patients diagnosed with clinical stage T2-T4aN0 M0 MIBC between 2004-2016. We considered patients to have received TMT if they received 55 Gy in 20 fractions or 59.4-70.2 Gy of radiotherapy with concurrent chemotherapy following a transurethral resection of bladder tumor (TURBT). We used multivariable Cox proportional hazard models to determine whether sex was associated with risk of mortality. In addition to OS, we calculated relative survival (RS) to adjust for the fact that females generally survive longer than males.

RESULTS: Of the patients, 1960 underwent TMT and had survival data. Less than one quarter were female. In the first year following treatment, women had worse OS and RS than men (p = 0.093 and p = 0.030, respectively). However, overall and relative survival differences between sexes were not statistically significantly different in Years 2 and later. Unlike with OS, the RS between sexes remained significant at 9 years; in multivariable analysis based on RS, women were 43% more likely to die than men (p < 0.001).

CONCLUSIONS: Women had a higher initial risk of death than men in the first year following TMT. However, long-term survival between sexes was similar. TMT is an important treatment option in both men and women seeking bladder preservation.

PMID:33779053 | DOI:10.1002/cam4.3835