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Nevin Manimala Statistics

Evaluation of qualitative and quantitative taste alterations in COVID-19

Bosn J Basic Med Sci. 2022 Jul 7. doi: 10.17305/bjbms.2022.6973. Online ahead of print.

ABSTRACT

Taste dysfunctions occur in a large proportion of COVID-19 patients. This observational study compared interleukin-6 (IL-6) levels in mild and moderate COVID-19 patients with the type (quantitative or qualitative) of taste disorders. The 208 COVID-19 patients (118 men and 90 women) showing only taste dysfunctions as prodromic symptoms were classified as mild and moderate patients. The evaluation of the taste disorder was carried out using a survey. The IL-6 levels were measured with a chemiluminescence assay. Statistical analysis was performed using the Wilcoxon rank, Welch’s, and Mann-Whitney tests (p <0.05). The results showed that there were no statistically significant differences in the perception of sour and salty, nor in the presence of dysgeusia and phantogeusia in moderate versus mild patients (p>0.05). However, there were statistically significant differences in the perception of umami, bitter, sweet, and the presence of parageusia in moderate versus mild patients (p<0.05). There was an impairment of multiple tastes up to ageusia in patients with high IL-6 levels. The results showed that dysfunctions in the perception of sweet, bitter, umami, and the presence of parageusia can be considered as signs of more severe forms of COVID-19.

PMID:35801415 | DOI:10.17305/bjbms.2022.6973

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Innovative pulmonary targeting of terbutaline sulfate-laded novasomes for non-invasive tackling of asthma: statistical optimization and comparative in vitro/in vivo evaluation

Drug Deliv. 2022 Dec;29(1):2058-2071. doi: 10.1080/10717544.2022.2092236.

ABSTRACT

Asthma represents a globally serious non-communicable ailment with significant public health outcomes for both pediatrics and adults triggering vast morbidity and fatality in critical cases. The β2-adrenoceptor agonist, terbutaline sulfate (TBN), is harnessed as a bronchodilator for monitoring asthma noising symptoms. Nevertheless, the hepatic first-pass metabolism correlated with TBN oral administration mitigates its clinical performance. Likewise, the regimens of inhaled TBN dosage forms restrict its exploitation. Consequently, this work is concerned with the assimilation of TBN into a novel non-phospholipid nanovesicular paradigm termed novasomes (NVS) for direct and effective TBN pulmonary targeting. TBN-NVS were tailored based on the thin film hydration method and Box-Behnken design was applied to statistically optimize the formulation variables. Also, the aerodynamic pattern of the optimal TBN-NVS was explored via cascade impaction. Moreover, comparative pharmacokinetic studies were conducted using a rat model. TBN elicited encapsulation efficiency as high as 70%. The optimized TBN-NVS formulation disclosed an average nano-size of 223.89 nm, ζ potential of -31.17 mV and a sustained drug release up to 24 h. Additionally, it manifested snowballed in vitro lung deposition behavior in cascade impactor with a fine particle fraction of 86.44%. In vivo histopathological studies verified safety of intratracheally-administered TBN-NVS. The pharmacokinetic studies divulged 3.88-fold accentuation in TBN bioavailability from the optimum TBN-NVS versus the oral TBN solution. Concisely, the results proposed that NVS are an auspicious nanovector for TBN pulmonary delivery with integral curbing of the disease owing to target specificity.

PMID:35801404 | DOI:10.1080/10717544.2022.2092236

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Effect of targeting and generator type on efficacy of extracorporeal shock wave lithotripsy

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022 Jun 27. doi: 10.5507/bp.2022.029. Online ahead of print.

ABSTRACT

OBJECTIVE: Analysis of the effect of technical factors, i.e. the type of stone targeting and shock wave generator, on ESWL efficacy. Evaluation of secondary outcomes to determine an optimal strategy for performing the procedure.

PATIENTS AND METHOD: In the period from 01/2016 to 07/2021, we analyzed data from patients indicated for ESWL for nephrolithiasis and proximal or distal ureterolithiasis. This was a tricenter retrospective study to evaluate stone-free rates (SFR) while taking into account the number of ESWL sessions in four selected groups of patients with comparable characteristics. A patient is considered stone-free in the absence of residual lithiasis or with an asymptomatic residue of up to 2 mm. The real-time ultrasound-guided (USG) arm consisted of a group of 120 patients on the electromagnetic STORZ SLK lithotripter in the period from 02/2017 to 02/2020. A total of three comparison arms with x-ray guidance were created: A: 68 patients between 01/2016 and 03/2017 on the Medilit 7 electrohydraulic lithotripter. B: 72 patients from 04/2017 to 10/2017 on the Sonolith i-sys electroconductive lithotripter (EDAP). C: 120 patients from 03/2018 to 07/2021 on the STORZ SLK electromagnetic lithotripter. By comparing the US and x-ray guidance using the STORZ SLK lithotripter, the effect of targeting when using an identical device (electromagnetic generator) was evaluated. By comparing the arms A, B, and C, the efficacy in different types of generators – electromagnetic, electroconductive, electrohydraulic – was assessed when the same type of targeting (fluoroscopy) was used. The secondary parameters that were monitored included: the rate of use of auxiliary techniques in stone management; radiation exposure for the patient and/or operator; analgesic consumption; and the time required to perform the procedure.

RESULTS: When US versus x-ray guidance was compared in an electromagnetic lithotripter, SFRs of 90% vs. 85% (P=0.329), i.e. statistically comparable results, were obtained. By comparing electromagnetic, electroconductive, and electrohydraulic generators with fluoroscopy, SFRs of 85%, 88.9%, and 88.2% were obtained, respectively (P=0.727). When the degree of need for intraoperative analgesic administration was assessed, the electromagnetic generator was found to have a significantly lower consumption (20.8% vs. 30.6% vs. 48.5%) (P=0.0005). Values less than 1095 HU and 108.5 mm were shown to be optimal cut-off values for stone density and skin-to-stone distance, respectively.

CONCLUSION: Based on our comparative analysis, the noninferiority of US stone targeting was demonstrated compared to fluoroscopic targeting. No significant differences in ESWL efficacy were found using electrohydraulic, electroconductive or electromagnetic shock wave generators. With the electromagnetic lithotripter, there was a significantly lower analgesic consumption than with the electrohydraulic type.

PMID:35801399 | DOI:10.5507/bp.2022.029

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Deciphering the offensive process in women’s elite football: a multivariate study

Scand J Med Sci Sports. 2022 Jul 8. doi: 10.1111/sms.14206. Online ahead of print.

ABSTRACT

Over the last few years there has been considerable increase in scientific knowledge about women’s football. However, the tactical and tactical-strategic aspects have not yet been sufficiently covered in scientific literature. Therefore, this work proposed the following aims: to describe how the offensive phase is produced in women’s football, to identify the significant statistical criteria that may be modulating success in attack, and finally to propose different predictive success models, with the ultimate aim of passing this knowledge on to the applied field. The observational methodology was used, one of the most appropriate methodologies for the analysis of motor behaviors in sport. The units of analysis collected and analysed were 6,063 attacks carried out during the FIFA Women’s World Cup Canada 2015 and France 2019. The available results demonstrate that, on the one hand, offensive team actions are ineffective (almost 70% finish unsuccessfully), but criteria such as the start form of the attack, zone of ball possession, partial match result or ball possession time are statistically significant criteria that modulate attack success (goal, shot or pass into the area). Lastly, the multivariate results allow us to propose a theoretical model, passing the probability of success from 31% in the absence of a model, to a theoretical auction probability of 52.6%, based on fast attacks with the intervention of few players, and with possession zone in the opposite field. These results could be directly transferred to the practical field where trainers and technical bodies can put this information into practice in training sessions or matches.

PMID:35801395 | DOI:10.1111/sms.14206

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A novel mouse model of cutaneous T cell lymphoma revealed the combined effect of Mogamulizumab with psoralen and ultraviolet A therapy

Exp Dermatol. 2022 Jul 8. doi: 10.1111/exd.14641. Online ahead of print.

ABSTRACT

Mycosis fungoides (MF) is a subtype of cutaneous T cell lymphoma (CTCL). Topical or systemic treatment with psoralen, such as 8-methoxypsoralen (8-MOP), followed by ultraviolet A (UVA) irradiation (PUVA therapy) is an effective phototherapy for early-stage MF. However, the efficacy of PUVA therapy for advanced-stage MF is not satisfactory, and the ideal combination partner for PUVA therapy has not yet been found. In this study, we developed a new mouse model of CTCL in which efficacy of PUVA was detected and further evaluated the efficacy of combination treatment of PUVA and mogamulizumab, an anti-CCR4 monoclonal antibody. Cytotoxicity of PUVA therapy against HH cells, a CTCL cell line, was observed in vitro. The cytotoxicity was dependent on both 8-MOP and UVA. Using HH cells, we developed a mouse model in which HH cells were subcutaneously inoculated in the ear. In this model, PUVA therapy suppressed tumor growth with statistical significance, while 8-MOP or UVA alone did not. Combination therapy of PUVA and mogamulizumab showed greater antitumor activity than either monotherapy with statistical significance. In the histological analysis of the tumor tissue, PUVA accelerated tumor necrosis and then induced the infiltration inflammatory cells in the necrotic area, suggesting that these cells served as effector cells for mogamulizumab. This combination therapy is expected to be a beneficial option for CTCL therapy.

PMID:35801380 | DOI:10.1111/exd.14641

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The inhibition of mineralisation by fibroblast growth factor 2 is associated with the altered expression of genes regulating phosphate balance

Aust Endod J. 2022 Jul 8. doi: 10.1111/aej.12656. Online ahead of print.

ABSTRACT

The study aimed to determine whether inhibitory effects of fibroblast growth factor 2 (FGF2) on mineralisation in dental pulp (DP) cultures were associated with changes in the expression of genes regulating phosphate balance (Enpp1, Ank, Slc20a2, Alpl, Phospho1, and Xpr1). DP cultures growing under mineralisation-inducing conditions were exposed to FGF2 and inhibitors of the FGFR and MEK/ERK1/2 signaling pathways. Mineralisation, culture cellularity, and gene expression were examined at various time points. Statistical analysis was performed using analysis of variance followed by the Holm-Šídák test. Control cultures exhibited transient increases in Enpp1 and Ank, continuous increases in Alpl, Phospho1, and Xpr1, and continuous decreases in Slc20a2. FGF2 increased Enpp1, Ank, and Slc20a2 and decreased Alpl, Phospho1, and Xpr1, whereas the FGF2 withdrawal and inhibition of FGFR and MEK/ERK1/2 exerted opposite effects. These changes suggest that FGF2-mediated decreases in mineralisation could be functionally coupled to the altered regulation of phosphate formation and transport.

PMID:35801357 | DOI:10.1111/aej.12656

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A Randomized Double-Blind Study Evaluating Intraperitoneal Ropivacaine Nebulization With and Without Nalbuphine for Post-operative Analgesia in Laparoscopic Cholecystectomy

Turk J Anaesthesiol Reanim. 2022 Jun;50(3):219-224. doi: 10.5152/TJAR.2022.21108.

ABSTRACT

OBJECTIVE: Local anaesthetics administered into the peritoneal cavity have been successfully used for post-operative pain relief in minimally invasive laparoscopic procedures. We intended to study and compare nebulized intraperitoneal ropivacaine with and without nalbuphine, with a placebo for post-operative pain relief in these surgeries.

METHODS: A prospective, randomized double-blinded study was conducted over a period of 1 year after institutional ethical clearance, in patients undergoing elective laparoscopic cholecystectomy. Subjects were randomized into 3 groups (S: saline, R: ropivacaine, RN: ropiva- caine plus nalbuphine). The pain was assessed in the post-operative period using NRS scores (up to 24 hours). Kruskal-Wallis test was used for comparison, P < .05 was considered significant. Time to first rescue analgesia, total opioid requirement, and side effects were also recorded.

RESULTS: Groups were similar in terms of demographic data. Patients in the placebo group reported higher NRS scores than the other 2 study groups till 4 hours post-operative (earlier rescue analgesia). The addition of nalbuphine did not cause any statistically significant improvement in post-operative pain relief (NRS) as compared to ropivacaine administered alone. Intraperitoneal ropivacaine nebulization had no significant adverse effect as compared to placebo.

CONCLUSIONS: Ropivacaine nebulization with or without nalbuphine is more effective than placebo for post-operative pain relief after lapa- roscopic cholecystectomy without significant side effects. Addition of nalbuphine to ropivacaine nebulization does not significantly improve pain relief after laparoscopic cholecystectomy.

PMID:35801329 | DOI:10.5152/TJAR.2022.21108

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Predicting incident heart failure among patients with type 2 diabetes mellitus: the DM-CURE risk score

Diabetes Obes Metab. 2022 Jul 8. doi: 10.1111/dom.14806. Online ahead of print.

ABSTRACT

IMPORTANCE: Early identification and prediction of incident heart failure (HF) is important due to severe morbidity and mortality.

OBJECTIVE: This study aimed to predict onset HF among patients with diabetes.

DESIGN, SETTING, AND PARTICIPANTS: A time-varying Cox model was derived from ACCORD clinical trial to predict the risk of incident HF, defined by hospitalization for HF (HHF). External validation was performed on patient level data from the Harmony Outcome trial and Chronic Renal Insufficiency Cohort (CRIC) study. The model was transformed into integer-based scoring algorithm for 10-year risk evaluation.

EXPOSURES: A stepwise algorithm identified and selected predictors from demographic characteristics, physical examination, laboratory results, medical history, medication, and healthcare utilization, to develop a risk prediction model.

MAIN OUTCOMES AND MEASURES: The main outcome was incident HF, defined by HHF. C statistics and Brier score were used to assess model performance.

RESULTS: A total of 9,649 diabetic patients free of HF were used, with median follow-up of 4 years and 299 incident hospitalization of HF events. The model identified several predictors for the 10-year HF incidence risk score “DM-CURE”: socio-Demographic (education, age at T2DM diagnosis), Metabolic (HbA1c, SBP, BMI, HDL), diabetes-related Complications (MI, revascularization, cardiovascular medications, neuropathy, hypertension duration, albuminuria, UACR, ESKD), and healthcare Utilization (all-cause hospitalization, ER visits) for Risk Evaluation. Among them, the strongest impact factors for future HF were age at T2DM diagnosis, healthcare utilization, and cardiovascular disease-related variables. The model demonstrated good discrimination (C statistic: 0.838, 95% CI: 0.821-0.855) and calibration (Brier score: 0.006, 95% CI: 0.006-0.007) in the ACCORD data and a good performance in the validation data (Harmony: C statistic: 0.881, 95% CI: 0.863-0.899; CRIC: C statistic: 0.813, 95% CI: 0.794-0.833). The 10-year risk of incident HF increased in a graded fashion, from ≤1% in quintile 1 (score ≤ 14), 1-5% in quintile 2 (score 15-23), 5-10% in quintile 3 (score 24-27), 10-20% in quintile 4 (score 28-33), and ≥20% in quintile 5 (score >33).

CONCLUSIONS AND RELEVANCE: The DM-CURE model and score were useful for population risk stratification of incident HHF among patients with T2DM and can be easily applied in clinical practice. This article is protected by copyright. All rights reserved.

PMID:35801340 | DOI:10.1111/dom.14806

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Postoperative Atrial Fibrillation Reduced by Intraoperative and Postoperative Cell Saver System in Coronary Artery Bypass Graft Surgery

Turk J Anaesthesiol Reanim. 2022 Jun;50(3):173-177. doi: 10.5152/TJAR.2022.21121.

ABSTRACT

OBJECTIVE: Postoperative atrial fibrillation is commonly seen after cardiac surgery. One of the contributing factors is mediastinal shed blood and inflammation. Cell salvage techniques can reduce allogenic blood transfusion and reduce inflammation. The aim of this study was to investigate the reduction of postoperative atrial fibrillation by using the cell-salvage system.

METHODS: Patients who underwent isolated coronary artery bypass graft surgery (n = 498) were analyzed retrospectively in 2 groups. Postoperative atrial fibrillation group (n = 75) and non-postoperative atrial fibrillation group (n = 423). Preoperative and postoperative demographic and clini- cal data were compared between the 2 groups, respectively. Postoperative atrial fibrillation and possible contributing factors were analyzed with multinomial logistic regression analysis.

RESULTS: In the postoperative atrial fibrillation group, the patients’ age and European System for Cardiac Operative Risk Evaluation (Euroscore) were higher than in the non-postoperative atrial fibrillation group (P = .001 and P = .003, respectively). Postoperative intensive care unit stay and hospital stay were longer in the postoperative atrial fibrillation group than in the non-postoperative atrial fibrillation group (P = .001 and P = .046, respectively). There were no statistical differences in mortality between groups. The incidence of postoperative atrial fibrillation decreased with the use of cell saver system and low Euroscore.

CONCLUSION: The use of a cell salvage device intraoperatively and during the early postoperative period can decrease the incidence of postop- erative atrial fibrillation group.

PMID:35801322 | DOI:10.5152/TJAR.2022.21121

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Associations of Body Fat Distribution and Cardiometabolic Risk of Testicular Cancer Survivors After Cisplatin-Based Chemotherapy

JNCI Cancer Spectr. 2022 Jul 1;6(4):pkac030. doi: 10.1093/jncics/pkac030.

ABSTRACT

BACKGROUND: It is unknown how body fat distribution modulates the cardiometabolic risk of testicular cancer survivors after cisplatin-based chemotherapy.

METHODS: For 455 patients enrolled in the Platinum Study at Memorial Sloan Kettering Cancer Center, visceral (VAT) and subcutaneous (SAT) adipose tissue was quantified on prechemotherapy computed tomography. The VAT-to-SAT ratio was calculated as a quantitative measure of central adiposity. Endpoints were incidence of new posthemotherapy cardiometabolic disease (new antihypertensive, lipid-lowering, or diabetes medication), and postchemotherapy Framingham risk scores. Cox models and linear regression with interaction terms were applied. Postchemotherapy body fat distribution was analyzed in 108 patients. All statistical tests were 2-sided.

RESULTS: The baseline median age was 31 years (interquartile range [IQR] = 26-39 years), body mass index (BMI) was 26 kg/m2 (IQR = 24-29 kg/m2), and the VAT-to-SAT ratio was 0.49 (IQR = 0.31-0.75). The median follow-up was 26 months (IQR = 16-59 months). Higher prechemotherapy VAT-to-SAT ratios inferred a higher likelihood of new cardiometabolic disease among patients with a BMI of 30 kg/m2 or greater (age-adjusted hazard ratio = 3.14, 95% confidence interval = 1.02 to 9.71, P = .047), but not other BMI groups. The prechemotherapy VAT-to-SAT ratio was associated with postchemotherapy Framingham risk scores in univariate regression analysis (exp(β)-estimate: 2.10, 95% confidence interval = 1.84 to 2.39, P < .001); in a multivariable model, this association was stronger in younger vs older individuals. BMI increased in most patients after chemotherapy and correlated with increases in the VAT-to-SAT ratio (Spearman r = 0.39, P < .001).

CONCLUSIONS: In testicular cancer survivors, central adiposity is associated with increased cardiometabolic risk after cisplatin-based chemotherapy, particularly in obese or young men. Weight gain after chemotherapy occurs preferentially in the visceral compartment, providing insight into the pathogenesis of cardiovascular disease in this population.

PMID:35801305 | DOI:10.1093/jncics/pkac030