Tag: pubmed

J Clin Lab Anal. 2021 Mar 16:e23760. doi: 10.1002/jcla.23760. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying new molecular diagnostic markers for Mycoplasma Pneumoniae Pneumonia (MPP) has always been an essential topic since MPP cases have increased every year, especially among children. Here, we examined the correlation between serum level of Purinergic receptor P2X7, vitamin A, and 25-hydroxy vitamin D (25(OH)D) and the severity of MPP, aiming to identify molecules that have the potential to become diagnostic markers.

METHODS: This study was conducted on 186 cases aged 1-14 (136 MPP and 50 non-MPP patients). Serum levels of Purinergic receptor P2X7, vitamin A, 25(OH)D, and multiple inflammatory and immune factors were measured, compared, and tested for statistical significance.

RESULTS: Serum P2X7, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) levels were significantly increased in severe MPP patients, while serum vitamin A, 25(OH)D, IgA, and IgG levels were significantly decreased.

CONCLUSION: Our results demonstrated a positive correlation between serum P2X7 level and the severity of MPP, and negative correlations between serum levels of vitamin A and 25(OH)D and the severity of MPP, suggesting that high serum levels of P2X7 and low serum levels of vitamin A and 25(OH)D may indicate relatively severer MPP.

PMID:33724522 | DOI:10.1002/jcla.23760

Magn Reson Med. 2021 Mar 16. doi: 10.1002/mrm.28696. Online ahead of print.

ABSTRACT

PURPOSE: To explore if R₂ ‘ mapping can assess renal hypoxia in rabbits with ischemia reperfusion injury (IRI).

METHODS: Forty rabbits were randomly divided into 4 groups according to the clipping time: the sham group and 45 min, 60 min, and 75 min for the mild, moderate, and severe groups (with n = 10 each group), respectively. Intravenous furosemide (FU) was administered 24 h after IRI. All rabbits were performed 5 times (IRI_pre , IRI_24h , FU_5min , FU_12min , and FU_24min ) with a 3.0 Tesla MR. The R₂ ‘ values and the hypoxic scores were then recorded. The repeated measurement analysis of variance and Spearman correlation analysis was used for statistical analysis.

RESULTS: Compared to the baseline, the medullary R₂ ‘ values increased significantly 24 h after the IRI (baseline 19.31 ± 1.21 s^-1 , mild group 20.05 ± 1.26 s^-1 , moderate group 25.38 ± 1.38 s^-1 , and severe group 25.79 ± 1.10 s^-1 ; each P < .001). FU led to a significant decrease in the medullary R₂ ‘ value (sham group 11.17 ± 4.33 s^-1 , mild group 7.80 ± 0.74 s^-1 , moderate group 3.92 ± 0.28 s^-1 , and severe group 3.82 ± 0.23 s^-1 ; each P < .05). Quantitative hypoxic scores revealed significant differences among the 4 groups in the outer medulla (P < .001 each). The medullary R₂ ‘ differences (before and after intravenous FU) were significantly correlated with the hypoxic scores, respectively (P < .001).

CONCLUSION: R₂ ‘ mapping can evaluate the renal hypoxia in the procession of IRI in rabbits and might serve as a quantitative biomarker for IRI.

PMID:33724527 | DOI:10.1002/mrm.28696

Clin Cardiol. 2021 Mar 16. doi: 10.1002/clc.23596. Online ahead of print.

ABSTRACT

The association between the efficacy of mobile health and the occurrence and development of coronary heart disease (CHD) is still unclear. Mobile health can alleviate the risk factors for CHD. PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang, and VIP databases were searched from inception through May 28, 2020. Randomized controlled trials of the effect of mobile health in alleviating the risk factors of CHD’s occurrence and development were included. Risks of bias were assessed by two independent reviewers by using the RevMan 5.3, GRADEpro, and RoB2.0 to generate findings. Meta-analyses were performed to investigate the effects of mobile health on risk factors for CHD. Subgroup analyses were conducted. Sixteen randomized controlled trials, including 3898 patients with CHD, were included. Meta-analysis results showed that mobile health can reduce BMI (mean difference [MD] = – 1.24, 95% CI = – 2.02 to – 0.45, p < .05), waist circumference (MD = – 4.40, 95% CI = – 4.72 to – 4.08, p < .00001), total cholesterol (TC) level (MD = – 0.43, 95% CI = – 0.64 to – 0.22, p < 0.00001), low-density lipoprotein cholesterol (LDL-C) level (MD = – 0.31, 95% CI = – 0.48 to – 0.15, p < .05), diastolic blood pressure (MD = – 2.01, 95% CI = – 3.40 to – 0.623, p < .05), and depression (MD = – 8.32, 95% CI = – 12.83 to – 3.81, p < .05) and increase high-density lipoprotein cholesterol level (MD = 0.16, 95% CI = 0.01 to 0.32, p < .05) with statistically significant differences. The results of subgroup analyses indicated that the simple mobile health intervention has more remarkable advantages in reducing BMI, TC, LDL-C, and systolic blood pressure than the complex mobile health intervention. Mobile health can alleviate the risk factors for CHD and has a certain effect on the prevention and recovery of CHD. Simple mobile health has a remarkable advantage. Limited by the quantity and quality of included studies, future research enrolling high-quality studies should be taken to verify the above conclusions.

PMID:33724494 | DOI:10.1002/clc.23596

Hematol Oncol. 2021 Mar 16. doi: 10.1002/hon.2863. Online ahead of print.

ABSTRACT

OBJECTIVES: The plateau phase emerging during the treatment of multiple myeloma (MM) is known to last steadily for a certain period, even without treatment. Therefore, the treatment started at plateau phase is expected to be associated with a better outcome. In this study, this hypothesis was evaluated retrospectively for previously treated MM patients in Kansai Myeloma Forum database who received lenalidomide (LEN) with or without dexamethasone for the first time.

METHOD: Disease stability index (DSI) was defined as: (maximum – minimum values of M-protein during the 90 days before the start of LEN) divided by M-protein values at the start of LEN. The patients were classified to 3 groups: stable (S), DSI ≤0.25; increasing (I), DSI >0.25 with increasing M-protein; decreasing (D), DSI>0.25 with decreasing M-protein.

OUTCOMES: In univariate analysis of 352 patients, DSI, age, non-IgG type, and low albumin were statistically significant prognostic factor for both progression-free survival and overall survival. Multivariate analysis revealed that the median overall survival of the group I was significantly worse compared with that of group S or D (p=0.015).

CONCLUSION: DSI is an independent prognostic factor for treatment with LEN for previously treated MM. This article is protected by copyright. All rights reserved.

PMID:33724498 | DOI:10.1002/hon.2863

J Ultrasound Med. 2021 Mar 16. doi: 10.1002/jum.15674. Online ahead of print.

ABSTRACT

OBJECTIVES: Ultrasound (US) prediction of placenta accreta spectrum (PAS) in the first trimester may be aided by postprocessing mechanisms employing color pixel quantification near the bladder-uterine serosal interface. Our objective was to create a postprocessing algorithm of color images to identify findings associated with PAS and compare quantification to sonologist impression in prospectively obtained cine US images.

METHODS: Transverse transvaginal (TV) US color cines obtained in the first trimester as part of a prospective study were reviewed. Investigators blinded to clinical outcomes reviewed anonymized cines that were archived and labeled the bladder-uterine serosal interface. Color pixels within 2 cm of the defined bladder-uterine serosal interface were ascertained using a Python-based plugin in the Horos open-source DICOM viewer. A sonologist classified the findings as suspicious for invasion, indeterminate, or normal. Statistical analysis was performed using Wilcoxon rank-sum test, Cochran-Armitage trend test, and calculation of receiver-operating characteristic (ROC) curves.

RESULTS: Fifty-four studies met inclusion criteria. Of those, six (11%) required hysterectomy with pathologic confirmation of PAS. Women requiring hysterectomy had a significantly higher color Doppler pixel area than those not requiring hysterectomy (P = .0205). A significant trend was identified in the sonologist impression of invasion (P = .0003). ROC’s comparing sonologist impression to Doppler color imaging areas were comparable (P = .054).

CONCLUSIONS: Color Doppler mapping in the first trimester showed an increase in color pixel area near the bladder-uterine serosal interface in women requiring cesarean hysterectomy with histologically confirmed PAS at time of delivery, compared to women without hysterectomy or pathologic evidence of PAS.

PMID:33724510 | DOI:10.1002/jum.15674

J Med Virol. 2021 Mar 16. doi: 10.1002/jmv.26942. Online ahead of print.

ABSTRACT

Few studies exist on the clinical manifestation of COVID-19 in patients who previously had a common cold due to an endemic coronavirus (eCoV). In a retrospective scan of the data obtained in our microbiology laboratory, 64 patients who were diagnosed with an eCoV infection between 2016 and 2020 were identified. National COVID-19 surveillance data showed that four (6.2%) of 64 patients were infected with SARS-CoV-2 by the end of 2020 while, simultaneously, the COVID-19 prevalence in the city of Malatya ranged from 7.8% (PCR-based diagnosis) to 9.2% (total diagnosis). The differences were found statistically significant (6.2 vs 7.8%, p<0.01; 6.2 vs 9.2%, p<0.001). Patient interviews and evaluation of medical records revealed that these four patients did not manifest any severe COVID-19 symptoms despite their substantial co-morbidities, and they did not require hospitalization. Consequently, despite a low number of samples, we determined a lower frequency of COVID-19 among the patients who had a prior eCoV infection, and the results of this study support the previous findings that people with a prior eCoV infection develop a milder case of COVID-19. Our results may provide some insights for future studies aiming at vaccine development, but detailed investigations are still required. This article is protected by copyright. All rights reserved.

PMID:33724483 | DOI:10.1002/jmv.26942

Cochrane Database Syst Rev. 2021 Mar 16;3:CD013639. doi: 10.1002/14651858.CD013639.pub4.

ABSTRACT

BACKGROUND: The respiratory illness caused by SARS-CoV-2 infection continues to present diagnostic challenges. Our 2020 edition of this review showed thoracic (chest) imaging to be sensitive and moderately specific in the diagnosis of coronavirus disease 2019 (COVID-19). In this update, we include new relevant studies, and have removed studies with case-control designs, and those not intended to be diagnostic test accuracy studies.

OBJECTIVES: To evaluate the diagnostic accuracy of thoracic imaging (computed tomography (CT), X-ray and ultrasound) in people with suspected COVID-19.

SEARCH METHODS: We searched the COVID-19 Living Evidence Database from the University of Bern, the Cochrane COVID-19 Study Register, The Stephen B. Thacker CDC Library, and repositories of COVID-19 publications through to 30 September 2020. We did not apply any language restrictions.

SELECTION CRITERIA: We included studies of all designs, except for case-control, that recruited participants of any age group suspected to have COVID-19 and that reported estimates of test accuracy or provided data from which we could compute estimates.

DATA COLLECTION AND ANALYSIS: The review authors independently and in duplicate screened articles, extracted data and assessed risk of bias and applicability concerns using the QUADAS-2 domain-list. We presented the results of estimated sensitivity and specificity using paired forest plots, and we summarised pooled estimates in tables. We used a bivariate meta-analysis model where appropriate. We presented the uncertainty of accuracy estimates using 95% confidence intervals (CIs).

MAIN RESULTS: We included 51 studies with 19,775 participants suspected of having COVID-19, of whom 10,155 (51%) had a final diagnosis of COVID-19. Forty-seven studies evaluated one imaging modality each, and four studies evaluated two imaging modalities each. All studies used RT-PCR as the reference standard for the diagnosis of COVID-19, with 47 studies using only RT-PCR and four studies using a combination of RT-PCR and other criteria (such as clinical signs, imaging tests, positive contacts, and follow-up phone calls) as the reference standard. Studies were conducted in Europe (33), Asia (13), North America (3) and South America (2); including only adults (26), all ages (21), children only (1), adults over 70 years (1), and unclear (2); in inpatients (2), outpatients (32), and setting unclear (17). Risk of bias was high or unclear in thirty-two (63%) studies with respect to participant selection, 40 (78%) studies with respect to reference standard, 30 (59%) studies with respect to index test, and 24 (47%) studies with respect to participant flow. For chest CT (41 studies, 16,133 participants, 8110 (50%) cases), the sensitivity ranged from 56.3% to 100%, and specificity ranged from 25.4% to 97.4%. The pooled sensitivity of chest CT was 87.9% (95% CI 84.6 to 90.6) and the pooled specificity was 80.0% (95% CI 74.9 to 84.3). There was no statistical evidence indicating that reference standard conduct and definition for index test positivity were sources of heterogeneity for CT studies. Nine chest CT studies (2807 participants, 1139 (41%) cases) used the COVID-19 Reporting and Data System (CO-RADS) scoring system, which has five thresholds to define index test positivity. At a CO-RADS threshold of 5 (7 studies), the sensitivity ranged from 41.5% to 77.9% and the pooled sensitivity was 67.0% (95% CI 56.4 to 76.2); the specificity ranged from 83.5% to 96.2%; and the pooled specificity was 91.3% (95% CI 87.6 to 94.0). At a CO-RADS threshold of 4 (7 studies), the sensitivity ranged from 56.3% to 92.9% and the pooled sensitivity was 83.5% (95% CI 74.4 to 89.7); the specificity ranged from 77.2% to 90.4% and the pooled specificity was 83.6% (95% CI 80.5 to 86.4). For chest X-ray (9 studies, 3694 participants, 2111 (57%) cases) the sensitivity ranged from 51.9% to 94.4% and specificity ranged from 40.4% to 88.9%. The pooled sensitivity of chest X-ray was 80.6% (95% CI 69.1 to 88.6) and the pooled specificity was 71.5% (95% CI 59.8 to 80.8). For ultrasound of the lungs (5 studies, 446 participants, 211 (47%) cases) the sensitivity ranged from 68.2% to 96.8% and specificity ranged from 21.3% to 78.9%. The pooled sensitivity of ultrasound was 86.4% (95% CI 72.7 to 93.9) and the pooled specificity was 54.6% (95% CI 35.3 to 72.6). Based on an indirect comparison using all included studies, chest CT had a higher specificity than ultrasound. For indirect comparisons of chest CT and chest X-ray, or chest X-ray and ultrasound, the data did not show differences in specificity or sensitivity.

AUTHORS’ CONCLUSIONS: Our findings indicate that chest CT is sensitive and moderately specific for the diagnosis of COVID-19. Chest X-ray is moderately sensitive and moderately specific for the diagnosis of COVID-19. Ultrasound is sensitive but not specific for the diagnosis of COVID-19. Thus, chest CT and ultrasound may have more utility for excluding COVID-19 than for differentiating SARS-CoV-2 infection from other causes of respiratory illness. Future diagnostic accuracy studies should pre-define positive imaging findings, include direct comparisons of the various modalities of interest in the same participant population, and implement improved reporting practices.

PMID:33724443 | DOI:10.1002/14651858.CD013639.pub4

J Small Anim Pract. 2021 Mar 15. doi: 10.1111/jsap.13320. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the association between signalment, selected haematologic and biochemical parameters and referral centre in pet rabbits with imaging evidence of urolithiasis presented to two veterinary teaching hospitals in North America.

MATERIALS AND METHODS: The medical record database of two veterinary teaching hospitals was searched from 2009 to 2019 for records of pet rabbits that received both imaging studies and plasma biochemistry profiles. Information regarding signalment, bodyweight, packed cell volume, total solids, and plasma biochemistry profiles was obtained. Univariable and multivariable logistic regression models were performed to identify statistically significant parameters associated with imaging evidence of urolithiasis.

RESULTS: Of the 324 examined rabbits, 33 (10.2%) had confirmed evidence of urolithiasis on imaging. Increasing plasma calcium and sodium concentrations and referral centre were significantly associated with the presence of urolithiasis on the univariable logistic regression model. However, only plasma calcium concentration and the referral centre demonstrated significant associations on the multivariable logistic regression model.

CLINICAL SIGNIFICANCE: Results indicate that urolithiasis in pet rabbits that receive imaging is associated with mildly increasing plasma calcium concentration and referral centre. The association with referral centre may indicate there are geographic influences on urolithiasis or on imaging. However, the identified associations have low predictive value for the diagnosis of urolithiasis, indicating the need for additional diagnostic modalities.

PMID:33724471 | DOI:10.1111/jsap.13320

Nat Commun. 2021 Mar 15;12(1):1672. doi: 10.1038/s41467-021-21819-8.

ABSTRACT

X-ray free-electron lasers (XFELs) enable obtaining novel insights in structural biology. The recently available MHz repetition rate XFELs allow full data sets to be collected in shorter time and can also decrease sample consumption. However, the microsecond spacing of MHz XFEL pulses raises new challenges, including possible sample damage induced by shock waves that are launched by preceding pulses in the sample-carrying jet. We explored this matter with an X-ray-pump/X-ray-probe experiment employing haemoglobin microcrystals transported via a liquid jet into the XFEL beam. Diffraction data were collected using a shock-wave-free single-pulse scheme as well as the dual-pulse pump-probe scheme. The latter, relative to the former, reveals significant degradation of crystal hit rate, diffraction resolution and data quality. Crystal structures extracted from the two data sets also differ. Since our pump-probe attributes were chosen to emulate EuXFEL operation at its 4.5 MHz maximum pulse rate, this prompts concern about such data collection.

PMID:33723266 | DOI:10.1038/s41467-021-21819-8

J Minim Access Surg. 2021 Apr-Jun;17(2):159-164. doi: 10.4103/jmas.JMAS_108_19.

ABSTRACT

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (RYGB) has been proven to induce significant weight loss and remission of related co-morbidities in patients with morbid obesity. The long-term follow-up data show weight regain or failure to achieve complete remission of type 2 diabetes mellitus (T2DM) in some patients. In this study, we report weight loss patterns and remission of T2DM in patients with morbid obesity during a 5-year follow-up after RYGB.

OBJECTIVE: The objective was to evaluate outcomes during the follow-up on excess weight loss (EWL) and remission of T2DM after laparoscopic RYGB among Indian patients.

SETTING: The study was conducted in a tertiary care hospital, Kerala, India.

MATERIALS AND METHODS: This is a retrospective study in patients who underwent surgery between 2007 and 2010. The patient demographics, pre- and post-operative body mass index (BMI), co-morbidities and EWL were recorded from the medical records. These data were compared between pre-operative and follow-up intervals till 5 years using statistical approaches.

RESULTS: The study included 157 patients (91 males and 66 females) having a mean pre-operative BMI of 47.91 ± 7.01 kg/m². A significant reduction in the BMI was observed at each follow-up point (P < 0.01) till 5 years after the surgery. The mean percentage of EWL increased from 34.57% ± 12.62% to 71.50% ± 15.41% from 3 months to 5 years after the surgery. Twelve per cent (n = 19) of patients achieved normal BMI (<25 mg/kg²) by 3^rd year after the surgery. However, the remission of T2DM was achieved in >50% of patients within a year of surgery. During the 5^th year, weight regain (1-22 kg) was observed in 36.70% (n = 58) patients, and recurrence of T2DM was observed in two patients.

CONCLUSIONS: The long-term durability of RYGB in the study population was satisfactory with significant weight loss and remission of T2DM.

PMID:33723179 | DOI:10.4103/jmas.JMAS_108_19