Tag: pubmed

Trop Doct. 2022 Feb 23:494755221074754. doi: 10.1177/00494755221074754. Online ahead of print.

ABSTRACT

Female genital tuberculosis (GTB) contributes significantly to infertility in low- and middle-income countries. Dissemination of infection from pulmonary and extrapulmonary sites is the major reason for causation of GTB. Additionally, sexual transmission of GTB from male partners has been reported. We selected 81 couples desiring babies from an in vitro fertilization clinic. We used multiplex-PCR for mycobacterial detection in semen of males, in the endometrium of their female counterparts and in the products of conception (POC) from miscarriage. Data interpretation shows that these pregnancies failed owing to sexual transmission of mycobacteria. We noticed by multiplex PCR that mycobacterial infestation in the female can take place in either endometrium or POC from asymptomatic males harbouring mycobacteria in their semen. Therefore, we propose sexual transfer of mycobacteria to be a probable cause of miscarriage. Thus, we suggest multiplex PCR based screening of semen for all males of the couples attempting successful childbirth.

PMID:35196202 | DOI:10.1177/00494755221074754

Physiother Theory Pract. 2022 Feb 23:1-9. doi: 10.1080/09593985.2022.2043497. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare muscle strength and flexibility among a subgroup of women with extension-related chronic nonspecific low back pain (CNLBP) with healthy controls.

METHODS: In this case-control study, 32 subjects with and without extension-related CNLBP were tested (n = 16 in each group). Gluteal, abdominal, paravertebral, and hamstring strength, along with hip flexor flexibility and hamstring flexibility were compared between groups. Data were analyzed using the Mann-Whitney test (p < .007).

RESULTS: The CNLBP subgroup displayed significantly lower strength of all muscles analyzed (p < .007), with the exception of gluteus medius. The flexibility of the hip flexors and hamstrings were not significantly reduced among the women with CNLBP (p > .007).

DISCUSSION: The present study showed that alterations in muscle strength, but not flexibility, partly consistent with those previously hypothesized but not objectively reported, were present among a subgroup of women with extension-related CNLBP. These results may have implications for the selection of therapeutic exercises among this subgroup of people with CNLBP.

PMID:35196207 | DOI:10.1080/09593985.2022.2043497

Expert Opin Drug Saf. 2022 Feb 23. doi: 10.1080/14740338.2022.2045946. Online ahead of print.

ABSTRACT

BACKGROUND: Stevens-Johnson syndrome is a rare but serious skin condition, which if left unattended can lead to death. Stevens-Johnson syndrome is usually attributed to drug-induced reactions, thus making it vital for clinicians to prevent its occurrence by knowing the trigger drugs. The objective of this study was to comprehensively and systematically excavate the drugs that cause SJS to provide references for clinicians to use drugs safely.

RESEARCH DESIGN AND METHODS: This is an observational, retrospective study, conducting a disproportionality analysis. Where the Information Component (IC) method and Reporting odds ratio (ROR) are used to mine the drugs that cause SJS.

RESULTS: A total of 17,787,905 reports were extracted from VigiBase database, of which 25,051 reports were related to SJS. The 18-44 age group had the largest number of cases (N=7,973, 31.83%). A total of 295 drugs was detected as signals. Allopurinol (IC025/ROR025=5.86/69.84), phenytoin (IC025/ROR025=5.60/57.65) and carbamazepine (IC025/ROR025=5.25/43.88) were the top 3 strongest signals. Our study only considered the possibility of SJS caused by a single drug.

CONCLUSIONS: Carbamazepine and allopurinol were two strongest signals in different age groups and gender groups. Garenoxaci, carbocisteine and dimetindene were strong signals, but there are no relevant cases reported on PubMed or specific SJS in labels, which need further study to verify.

PMID:35196201 | DOI:10.1080/14740338.2022.2045946

Minerva Endocrinol (Torino). 2022 Feb 23. doi: 10.23736/S2724-6507.21.03585-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Diabetic Retinopathy (DR) is a common microvascular complication of diabetes. This review reports the prevalence of DR in Asia and guides healthcare provision in screening and treatment.

EVIDENCE ACQUISITION: Medline was searched for articles describing the prevalence of DR in Asia. Statistical analysis was performed using freeman turkey double arcsine transformation and the DerSimonian and Laird model. The prevalence of DR was estimated according to the following subgroups: Economic status (High Income, Middle Income, Low Income), Country, and Ethnicity. The risk of bias of the articles was also assessed.

EVIDENCE SYNTHESIS: A total of 66 studies were included, and out of 2,599,857 patients with diabetes, 201,646 were diagnosed with DR. The overall prevalence of DR, nonproliferative DR (NPDR), proliferative DR (PDR) and maculopathy were recorded at 21.7% (CI:19.1% – 24.6%), 19.9% (CI:17.3% – 22.8%), 2.3% (CI:1.6% – 3.4%) and 4.8% (CI:3.5% – 6.7%) respectively. Low-income countries had the lowest prevalence of DR, NPDR, PDR and maculopathy compared to the middle- and high-income countries. Middle-income countries had the highest prevalence of DR (23.9%; CI:19.4% – 29.2%), NPDR (21.1%; CI:17.0% – 25.9%), moderate NPDR (7.9%; CI: 5.7% – 11.0%), PDR (3.0%; CI: 1.8% – 4.9%) and maculopathy (4.7%; CI:3.0% – 7.4%), while high-income countries had the highest prevalence of mild (10.3%; CI:4.2% – 23.2%) and severe NPDR (3.0%; CI:1.0% – 8.4%).

CONCLUSIONS: One in five people with diabetes have diabetic retinopathy. It is imperative that public healthcare take heeds to heighten the screening program to provide all patients with diabetes equitable access to DR screening and ophthalmology services.

PMID:35195381 | DOI:10.23736/S2724-6507.21.03585-5

Int Braz J Urol. 2022 Feb 2;47. doi: 10.1590/S1677-5538.IBJU.2021.0653. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to explore the prevalence and clinical risk factors in patients diagnosed with incidental prostate cancer (IPC) during certain surgeries (transurethral resection of the prostate [TURP], open prostatectomy [OP], and holmium laser enucleation of the prostate [HoLEP]) after clinically suspected benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS: Literature search of the MEDILINE, Web of Science, Embase, and Cochrane Library databases was performed to identify eligible studies published before June 2021. Multivariate adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) of the prevalence and clinical risk factors of IPC were calculated using random or fixed-effect models.

RESULTS: Twenty-three studies were included in the meta-analysis. Amongst the 94.783 patients, IPC was detected in 24.715 (26.1%). Results showed that the chance of IPC detection (10%, 95% CI: 0.07-4.00; P<0.001; I2=97%) in patients treated with TURP is similar to that of patients treated with HoLEP (9%, 95% CI: 0.07-0.11; P<0.001; I2=81.4%). However, the pooled prevalence estimate of patients treated with OP was 11% (95% CI: -0.03-0.25; P=0.113; I2=99.1%) with no statistical significance. We observed increased incidence of IPC diagnosis after BPH surgery amongst patients with higher prostate-specific antigen (PSA) level (OR: 1.13, 95% CI: 1.04-1.23; P=0.004; I2=89%), whereas no effect of age (OR: 1.02, 95% CI: 0.97-1.06; P=0.48; I2=78.8%) and prostate volume (OR: 0.99, 95% CI: 0.96-1.03; P=0.686; I2=80.5%) were observed.

CONCLUSIONS: The prevalence of IPC was similar amongst patients undergoing TURP, HoLEP, and OP for presumed BPH. Interestingly, increased PSA level was the only independent predictor of increasing risk of IPC after BPH surgery rather than age and prostate volume. Hence, future research should focus on predictors which accurately foretell the progression of prostate cancer to determine the optimal treatment for managing patients with IPC after BPH surgery.

PMID:35195386 | DOI:10.1590/S1677-5538.IBJU.2021.0653

Int J Lang Commun Disord. 2022 Feb 23. doi: 10.1111/1460-6984.12708. Online ahead of print.

ABSTRACT

BACKGROUND: Previous research has consistently evidenced that children with speech and language difficulties suffer more bullying victimisation during middle school years, whereas other educative stages remain less explored. Moreover, there are divergent results in previous evidence about the types of victimisation (physical, verbal, relational) youths may experience.

AIMS: To examine the retrospective developmental trajectories of bullying victimisation in adults with and without self-reported oral language difficulties across seven educational stages (preschool to university). Special attention was given to the prevalence and types of victimisation.

METHODS & PROCEDURES: A total of 336 participants (ages between 18 and 65, M = 30.3) from a sample of 2259 participants that fully answered an online survey were classified as having experienced oral language difficulties (LD) not associated with a biomedical condition. A comparable control group (n = 336; ages between 18 and 72, M = 30.0) was randomly selected for statistical between-groups contrasts. Responses to the California Bullying Victimization Scale-Retrospective (CBVS-R) were analysed by generalised estimating equations (GEE) including language groups, types of bullying, and educational stages as explanatory variables. Specific language group comparisons in terms of percentages were conducted using chi-square tests.

OUTCOMES & RESULTS: GEE results suggested that experiencing LD was associated with an overall increase in the likelihood of bullying victimisation, Wald’s χ² (1) = 8.41, p < 0.005 for the main effect of the LD group, along almost all educational stages, Wald’s χ² (6) = 3.13, p = 0.69 for the LD group × educational stage interaction. Finally, a higher proportion of participants in the LD group reported having suffered teasing behaviours at the second cycle of elementary, the first cycle of secondary, and baccalaureate. They also reported with a higher proportion being physically hurt at preschool and having received sexual comments at the second cycle of elementary, Wald’s χ² (93) = 259.87, p < 0.001 for the LD group × educational stage × type of bullying interaction.

CONCLUSIONS & IMPLICATIONS: People with oral language difficulties experience more bullying victimisation behaviours than their typically developing peers. Heightened bullying prevalence in children with language difficulties seems to emerge as early as 6-9 years old and persists along the rest of schooling. Not all victimisation forms seem to show differential increased rates in people with speech/language difficulties, evidencing important implications for bullying assessment. Results highlight the need to provide particular support to individuals with language difficulties against bullying during the entire schooling.

PMID:35195330 | DOI:10.1111/1460-6984.12708

J Magn Reson Imaging. 2022 Feb 23. doi: 10.1002/jmri.28125. Online ahead of print.

ABSTRACT

BACKGROUND: Quantitative MRI (qMRI) metrics reflect microstructural skeletal muscle changes secondary to denervation and may correspond to conventional electromyography (EMG) assessments of motor unit recruitment (MUR) and denervation.

HYPOTHESIS: Differences in quantitative T₂ , diffusion-based apparent fiber diameter (AFD), and fat fraction (FF) exist between EMG grades, in patients with clinically suspected neuropathy of the brachial plexus.

STUDY TYPE: Prospective.

POPULATION: A total of 30 subjects (age = 37.5 ± 17.5, 21M/9F) with suspected brachial plexopathy.

FIELD STRENGTH/SEQUENCE: 3-Tesla; qMRI using fast spin echo (T₂ -mapping), multi-b-valued diffusion-weighted echo planar imaging (for AFD), and dual-echo Dixon gradient echo (FF-mapping) sequences.

ASSESSMENT: qMRI values were compared against EMG grades (MUR and denervation). qMRI values (T₂ , AFD, and FF) were obtained for five regional shoulder muscles. A 4-point scale was used for MUR/denervation severity.

STATISTICAL TESTS: Linear mixed models and least-squares pairwise comparisons were used to evaluate qMRI differences between EMG grades. Predictive accuracy of EMG grades from qMRI was quantified by 10-fold cross-validated logistic models. A P value < 0.05 was considered statistically significant.

RESULTS: Mean (95% confidence interval) qMRI for “full” MUR were T₂ = 39.40 msec (35.72-43.08 msec), AFD = 78.35 μm (72.52-84.19 μm), and FF = 4.54% (2.11-6.97%). Significant T₂ increases (+8.36 to +14.67 msec) and significant AFD decreases (-11.04 to -21.58 μm) were observed with all abnormal MUR grades as compared to “full” MUR. Significant changes in both T₂ and AFD were observed with increased denervation (+9.59 to +15.04 msec, -16.25 to -18.66 μm). There were significant differences in FF between some MUR grades (-1.45 to +2.96%), but no significant changes were observed with denervation (P = 0.089-0.662). qMRI prediction of abnormal MUR or denervation was strong (mean accuracy = 0.841 and 0.810, respectively) but moderate at predicting individual grades (accuracy = 0.492 and 0.508, respectively).

DATA CONCLUSION: Quantitative T₂ and AFD differences were observed between EMG grades in assessing muscle denervation.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 1.

PMID:35195321 | DOI:10.1002/jmri.28125

Neurogastroenterol Motil. 2022 Feb 23:e14338. doi: 10.1111/nmo.14338. Online ahead of print.

ABSTRACT

BACKGROUND: Highly prevalent functional constipation (FC) belongs to the category of functional gastrointestinal disorders. Neuroimaging studies have demonstrated brain functional and morphometric changes in patients with FC. However, whether FC is associated with white-matter (WM) microstructural alterations remains unclear.

METHODS: Diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) were introduced to investigate WM microstructural changes as calculated by fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD) in 26 FC patients and 31 healthy controls.

KEY RESULTS: Patients with FC relative to healthy controls had significantly decreased FA with increased MD/RD in the genu (GCC) and body (BCC) of the corpus callosum, right cingulum (Cing), bilateral anterior corona radiata (ACR), bilateral superior corona radiata (SCR), and left posterior corona radiata (PCR) (p_FWE < 0.05). Between-group difference was only in the left SCR and PCR when regressing out anxiety and depression as covariates.

CONCLUSIONS AND INFERENCES: These WM tracts are mainly responsible for sensory and emotional information communication and corresponding functional integration; thus, our findings indicate an association between FC and WM microstructural abnormalities in regions involved with visceral afferent and emotional-arousal processing. Alterations in WM microstructures including the CC, cingulum, and ACR are more related to psychological symptoms than constipation, which might have greater impact on brain structures.

PMID:35195324 | DOI:10.1111/nmo.14338

Acta Obstet Gynecol Scand. 2022 Feb 23. doi: 10.1111/aogs.14334. Online ahead of print.

ABSTRACT

INTRODUCTION: Occult or untreated gestational diabetes (GDM) is a well-known risk factor for adverse perinatal outcomes and may contribute to antepartum stillbirth. We assessed the impact of screening for GDM on the rate of antepartum stillbirths in non-anomalous pregnancies by conducting a population-based study in 974 889 women in Austria.

MATERIAL AND METHODS: Our database was derived from the Austrian Birth Registry. Inclusion criteria were singleton live births and antepartum stillbirths ≥24⁺⁰ gestational weeks, excluding fetal congenital malformations, terminations of pregnancy and women with pre-existing type 1 or 2 diabetes. Main outcome measures were (a) overall stillbirth rates and (b) stillbirth rates in women at high risk of GDM (i.e., women with a body mass index ≥30 kg/m² , history of previous intrauterine fetal death, GDM, previous macrosomic offspring) before (2008-2010, “phase I”) and after (2011-2019, “phase II”) the national implementation of universal GDM screening with a 75 g oral glucose tolerance test in Austrian pregnant women by 2011.

RESULTS: In total, 940 373 pregnancies were included between 2008 and 2019, of which 2579 resulted in intrauterine fetal deaths at 33.51 ± 5.10 gestational weeks. After implementation of the GDM screening, a statistically significant reduction in antepartum stillbirth rates among non-anomalous singletons was observed only in women at high risk for GDM (4.10‰ [95% confidence interval (CI) 3.09-5.43] in phase I vs. 2.96‰ [95% CI 2.57-3.41] in phase II; p = 0.043) but not in the general population (2.76‰ [95% CI 2.55-2.99] in phase I vs. 2.74‰ [95% CI 2.62-2.86] in phase II; p = 0.845). The number needed to screen with the oral glucose tolerance test to subsequently prevent one case of (non-anomalous) intrauterine fetal death was 880 in the high-risk and 40 000 in the general population.

CONCLUSIONS: The implementation of a universal GDM screening programme in Austria in 2011 has not led to any significant reduction in antenatal stillbirths among non-anomalous singletons in the general population. More international data are needed to strengthen our findings.

PMID:35195277 | DOI:10.1111/aogs.14334

Cancer. 2022 Feb 23. doi: 10.1002/cncr.34154. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer cachexia is a syndrome characterized by anorexia and decreased body weight. This study evaluated the efficacy and safety of anamorelin, an orally active, selective ghrelin receptor agonist, in patients with cancer cachexia and a low body mass index (BMI).

METHODS: This multicenter, open-label, single-arm study enrolled Japanese patients with non-small cell lung cancer or gastrointestinal cancer with cancer cachexia (BMI < 20 kg/m² , involuntary weight loss > 2% in the last 6 months, and anorexia). Patients were administered 100 mg of anamorelin once daily for up to 24 weeks. The primary end point was a composite clinical response (CCR) at 9 weeks, which was defined as an increase in body weight of ≥5% from the baseline, an increase of ≥2 points in the score of the 5-item Anorexia Symptom Scale of the Functional Assessment of Anorexia/Cachexia Therapy, and being alive.

RESULTS: One hundred two patients were eligible and enrolled. The means and standard deviations for age and BMI were 71.0 ± 8.2 years and 17.47 ± 1.48 kg/m² , respectively. The CCR rate at 9 weeks was 25.9% (95% confidence interval [CI], 18.3%-35.3%), which met the primary end point with a lower 95% CI exceeding the prespecified minimum of 8%. Improvements in body weight and anorexia were durable and were accompanied by improvements in patients’ global impression of change for appetite/eating-related symptoms and overall condition. Adverse drug reactions occurred in 37 of 101 treated patients (36.6%), with the most common being glycosylated hemoglobin increases, constipation, and peripheral edema.

CONCLUSIONS: Anamorelin improved body weight and anorexia-related symptoms in patients with cancer cachexia and a low BMI with durable efficacy and favorable safety and tolerability.

LAY SUMMARY: Anamorelin is a drug that stimulates appetite and promotes weight gain. This clinical trial was aimed at determining its efficacy and safety in Japanese cancer patients with a low body mass index and cachexia, a syndrome associated with anorexia and weight loss. Anamorelin was found to improve body weight and anorexia-related symptoms in these patients, and these effects were durable for up to 24 weeks. Moreover, anamorelin was generally well tolerated. These findings suggest that anamorelin is a valuable treatment option for patients with cancer cachexia and a low body mass index.

PMID:35195274 | DOI:10.1002/cncr.34154