Tag: pubmed

Lancet Oncol. 2022 Jul;23 Suppl 1:S26. doi: 10.1016/S1470-2045(22)00425-9.

ABSTRACT

BACKGROUND: Oral squamous cell carcinoma is a substantial health burden and one of the most common cancers worldwide. 40% of patients with oral squamous cell carcinoma have metastasis to cervical lymph nodes. Modern diagnostic aids for the assessment of lymph node metastasis have some limitations and drawbacks. miR-21 targets genes associated with the metastatic process in oral squamous cell carcinoma. The aim of the study was to evaluate the sensitivity and specificity of miR-21 for the assessment of cervical lymph node metastasis in patients with oral squamous cell carcinoma.

METHODS: This work was conducted at Sumandeep Vidyapeeth, Vadodara, India. Unstimulated whole saliva and tumour tissue was obtained from patients with a clinically suspicious oral squamous cell carcinoma. The assessment of cervical lymph node metastasis was done before surgery by imaging techniques (CT or MRI) and post-surgically confirmed by histopathological examination of excised lymph nodes. miR-21 expression was evaluated using real-time PCR. Data were analysed for correlation analysis, cutoff values, sensitivity, and specificity. Kappa statistics were applied to assess the degree of agreement between the lymph node metastasis and miR-21 expression.

FINDINGS: 130 patients diagnosed with oral squamous cell carcinoma were included. miR-21 expression showed a significant correlation with cervical lymph node metastasis, with a diagnostic accuracy of 65-72% in saliva and 69-82% in tumour tissue. The mean cutoff value, defined as the value of fold (ie, to the power of) change indicating maximum sensitivity and specificity of miR-21 expression, was 2·32 cycle threshold (ct) for miR-21-5p (sensitivity 42·6%, specificity 90·3%) and 2·16 ct for miR-21-3p (sensitivity 60·3%, specificity 83·9%) in saliva, and 1·80 ct for miR-21-5p (sensitivity 76·5%, specificity 61·3%) and 0·89 ct for miR-21-3p in tumour tissue (sensitivity 82·4%, specificity 80·6%). We observed that when miR-21 expression is above the cutoff score, the probability of lymph node metastasis was higher. The independent t test showed a significant correlation (p<0·001) between cervical lymph node metastasis and miR-21 expression in saliva and tumour tissue, but not for miR-21-3p expression in tumour tissue (p=0·11). Very good agreement (Cohen’s kappa=0·63) was observed between tumour tissue miR-21-3p and cervical lymph node metastasis, with a specificity of 80·60% and a sensitivity of 82·40%. The statistical analysis for correlation between saliva and tumour tissue miR-21 expression and age, sex, site of tumour (eg, buccal mucosa, tongue), and tobacco consumption habits did not show any significant correlation, but a significant correlation was observed with one-way ANOVA testing for the comparison between TNM stage and miR-21-5p and miR-21-3p expression in saliva and tumour tissue (p<0·0001).

INTERPRETATION: miR-21 expression in saliva and tumour tissue samples from patients with oral squamous cell carcinoma showed high diagnostic accuracy for assessment of cervical lymph node metastasis, and it could be used as an alternative for the assessment of cervical lymph node metastasis before surgery.

FUNDING: None.

PMID:35837922 | DOI:10.1016/S1470-2045(22)00425-9

Ann Surg. 2022 Jul 15. doi: 10.1097/SLA.0000000000005552. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Studies indicate that COVID-19 infection before or soon after operations increases mortality, but they do not comment on the appropriate timing for interventions after diagnosis. We sought to determine what the safest time would be for COVID-19 diagnosed patients to undergo major operative interventions.

METHODS: High-risk operations, between January 2020 and May 2021, were identified from the Veterans Affairs COVID-19 Shared Data Resource. Current Procedural Terminology (CPT) codes were used to exact match COVID-19 positive cases (n=938) to negative controls (n=7,235). Time effects were calculated as a continuous variable and then grouped into two-week intervals. The primary outcome was 90-day, all-cause postoperative mortality.

RESULTS: 90-day mortality in cases and controls was similar when the operation was performed within 9 weeks or longer after a positive test; but significantly higher in cases vs. controls when the operation was performed within 7-8 weeks (12.3% vs. 4.9%), 5-6 weeks (10.3 vs. 3.3%), 3-4 weeks (19.6 vs. 6.7%), and 1-2 weeks (24.7 vs. 7.4%) from diagnosis. Among patients who underwent surgery within 8 weeks from diagnosis, 90-day mortality was 16.6% for cases vs. 5.8% for the controls (P<0.001). In this cohort, we assessed interaction between case status and any symptom (P=0.93), and case status and either respiratory symptoms or fever (P=0.29), neither of which were significant statistically.

CONCLUSIONS: Patients undergoing major operations within 8 weeks after a positive test have substantially higher postoperative 90-day mortality than CPT-matched controls without a COVID-19 diagnosis, regardless of presenting symptoms.

PMID:35837893 | DOI:10.1097/SLA.0000000000005552

Minerva Surg. 2022 Jul 15. doi: 10.23736/S2724-5691.22.09607-1. Online ahead of print.

ABSTRACT

BACKGROUND: Nipple reconstruction, which allows a reconstructed breast to assume a more natural look, represents the completion of the breast reconstruction journey. Several techniques have already been described in literature but unfortunately, loss of the projection of the new nipple has been a common problem for all of them. We report our experience using a personal modification of the popular arrow flap, to which we have added manoeuvres to compensate for the weaknesses of the conventional procedures.

METHODS: A prospective study was performed on women who required nipple reconstruction after autologous or implant-based breast reconstruction; revisions of reconstructed nipples have been also included. Patients who underwent radiotherapy after reconstruction of the breast mound were excluded from the study. The new nipples were reconstructed using our modified arrow flap. Immediate post-operative nipple projection was recorded and compared after 6weeks and 6moths. Descriptive statistics were used to summarize the characteristics of the study patients and the results. The F-test was performed to assess the statistical significance of our findings.

RESULTS: Our modified arrow-flap procedure was used to reconstruct 27 nipples. The average projection reduction has been of 12,9% at 6weeks and 19,7% at 6 months, and no statistical significance was recorded among the postoperative assessments. (p=0.14). Complications have been recorded in 3 patients and consisted of 2 small wound dehiscence and 1 superficial infection.

CONCLUSIONS: Our modified arrow-flap method for nipple reconstruction achieves a reproducible and reliable natural look and stable projection.

PMID:35837873 | DOI:10.23736/S2724-5691.22.09607-1

Exp Dermatol. 2022 Jul 15. doi: 10.1111/exd.14645. Online ahead of print.

ABSTRACT

The analytical technology of Raman spectroscopy has an almost 100-year history. During this period many modifications and developments happened in the method like discovery of laser, improvements in optical elements and sensitivity of spectrometer and also more advanced light detection systems. Many types of the innovative techniques appeared (e.g. Transmittance Raman spectroscopy, Coherent Raman Scattering microscopy, Surface Enhanced Raman scattering and Confocal Raman spectroscopy/microscopy). This review article gives a short description about these different Raman techniques and their possible applications. Then a short statistical part is coming about the appearance of Raman spectroscopy in the scientific literature from the beginnings to these days. The third part of the paper shows the main application options of the technique (especially confocal Raman spectroscopy) in skin research, including skin composition analysis, drug penetration monitoring and analysis, diagnostic utilizations in dermatology and cosmeto-scientific applications. At the end the possible role of artificial intelligence in Raman data analysis and the regulatory aspect of this techniques in dermatology are briefly summarized. For the future of Raman Spectroscopy increasing clinical relevance and in vivo applications can be predicted with spreading of non-destructive methods and appearance with the most advanced instruments with rapid analysis time.

PMID:35837832 | DOI:10.1111/exd.14645

Allergy Asthma Immunol Res. 2022 Jul;14(4):439. doi: 10.4168/aair.2022.14.4.439.

ABSTRACT

This corrects the article on p. 289 in vol. 14, PMID: 35557494.

PMID:35837826 | DOI:10.4168/aair.2022.14.4.439

J Asthma. 2022 Jul 15:1-7. doi: 10.1080/02770903.2022.2093218. Online ahead of print.

ABSTRACT

BACKGROUND: Patient education is a key element in the management of asthma.

AIMS: This study aimed to evaluate the popularity and usefulness of YouTube videos on asthma.

METHODS: Two authors screened and evaluated the 200 most popular videos. Data on likes, dislikes, views, comment, source of uploader, days since upload, and usefulness were recorded and included for analyses. The usefulness of the videos was categorized as follows: useful, misleading, or neutral. Misleading videos provided at least one scientifically incorrect detail, whereas useful videos contained scientifically correct information.

RESULTS: A total of 130 videos were included, and the total number of views was 100,290,242 with a total duration of 29 h and 8 min. While 26.6% of videos were uploaded by TV shows and YouTube channels, only 7.7% were uploaded by lung specialists. 65.4% of the videos contained scientifically correct information, whereas 18.5% contained misleading information. Although videos from medical professionals had a higher quality than videos from YouTube channels and TV shows, the latter were more popular. Misleading videos had numerically, but not statistically significant higher views compared with useful videos.

CONCLUSIONS: YouTube videos on asthma are popular in terms of viewer interaction, and the popularity is not restricted to videos uploaded by professional sources. Although more than half of the videos were found to be useful, a non-negligible proportion of videos were assessed as misleading. The usefulness of YouTube videos on asthma is variable and initiatives should be taken to increase the potential of YouTube as an useful source in patient education.

PMID:35837808 | DOI:10.1080/02770903.2022.2093218

Eur J Neurol. 2022 Jul 15. doi: 10.1111/ene.15496. Online ahead of print.

ABSTRACT

AIMS: To explore associations between plasma neurofilament light chain concentration (pNfL; pg/mL) and disease activity in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and examine the usefulness of pNfL concentrations in determining disease remission.

METHODS: We examined pNfL concentrations in treatment-naïve CIDP patients (n=10) before and after intravenous immunoglobulin (IVIg) induction treatment, differences in pNfL concentrations in patients on maintenance IVIg treatment who had stable (n=15) or unstable disease (n=9), and in clinically stable IVIg-treated patients (n=10) in whom we suspended IVIg to determine disease activity and ongoing need for maintenance IVIg. pNfL concentrations in an age-matched healthy control group were measured for comparison.

RESULTS: Treatment-naïve patients: pNfL concentration was higher in patients before IVIg treatment than healthy controls and subsequently reduced comparable to control group values after IVIg induction. CIDP patients on IVIg treatment: pNfL concentration was significantly higher in unstable patients than stable patients. A pNFL concentration above 16.6 pg/mL identified unstable treated CIDP from stable treated CIDP (sensitivity= 86.7%, specificity= 66.7%, area under ROC= 0.73). Treatment withdrawal group: There was statistically significant correlation between pNfL concentration at time of IVIg withdrawal and the likelihood of relapse (r=0.72, p<0.05), suggesting an association of higher pNfL concentration with active disease.

CONCLUSION: pNfL concentrations may be a sensitive, clinically useful biomarker in assessing subclinical disease activity.

PMID:35837802 | DOI:10.1111/ene.15496

Res Synth Methods. 2022 Jul 15. doi: 10.1002/jrsm.1591. Online ahead of print.

ABSTRACT

The variance-stabilizing Freeman-Tukey double arcsine transform was originally proposed for inference on single proportions. Subsequently, its use has been suggested in the context of meta-analysis of proportions. While some erratic behaviour has been observed previously, here we point out and illustrate general issues of monotonicity and invertibility that make this transform unsuitable for meta-analysis purposes. This article is protected by copyright. All rights reserved.

PMID:35837800 | DOI:10.1002/jrsm.1591

Dermatol Ther. 2022 Jul 15:e15717. doi: 10.1111/dth.15717. Online ahead of print.

ABSTRACT

BACKGROUND: Various treatment methods are used for noninvasive body contouring.

OBJECTIVE: To evaluate the efficacy and safety of a newly designed cryolipolysis device using a three-dimensional cooling method for abdominal fat reduction.

METHODS: Twenty-five participants with clinically apparent abdominal fat tissue participated in the study. The thickness of fat tissue below the umbilicus level was measured using a caliper at baseline and 12 weeks after the first treatment. The height of abdominal subcutaneous fat tissue on ultrasonography and participant satisfaction were assessed at every visit for 16 weeks. All adverse events (AEs) during the study period were recorded. P values <0.05 were considered statistically significant.

RESULTS: Twenty-four participants completed this study; the mean BMI of participants was 29.34±2.36 kg/m² . The mean thickness of abdominal subcutaneous fat was significantly lower at 12 weeks (40.4±6.8 mm, p<0.001) than at baseline (49.3±8.5 mm). Differences in the height of abdominal subcutaneous fat compared to that at baseline were 1.02±0.41 cm (12 weeks, p<0.001) and 1.13±0.44 cm (16 weeks, p<0.001). Rates of abdominal subcutaneous fat reduction at 12 and 16 weeks compared to that at baseline were 28.45% and 31.13%, respectively. The ratio of abdominal circumference to hip circumference at 12 and 16 weeks was significantly decreased compared to that at baseline. Most participants (95.8%) reported improvement in satisfaction scores at 16 weeks. There were no serious AEs during the entire study period.

CONCLUSION: The study demonstrated the efficacy of a noninvasive cryolipolysis device using a three-dimensional cooling method for reducing abdominal subcutaneous fat. This article is protected by copyright. All rights reserved.

PMID:35837791 | DOI:10.1111/dth.15717

Acta Neuropathol Commun. 2022 Jul 14;10(1):103. doi: 10.1186/s40478-022-01399-4.

ABSTRACT

Dementia with Lewy bodies (DLB) is clinically diagnosed when patients develop dementia less than a year after parkinsonism onset. Age is the primary risk factor for DLB and mitochondrial health influences ageing through effective oxidative phosphorylation (OXPHOS). Patterns of stable polymorphisms in the mitochondrial genome (mtDNA) alter OXPHOS efficiency and define individuals to specific mtDNA haplogroups. This study investigates if mtDNA haplogroup background affects clinical DLB risk and neuropathological disease severity. 360 clinical DLB cases, 446 neuropathologically confirmed Lewy body disease (LBD) cases with a high likelihood of having DLB (LBD-hDLB), and 910 neurologically normal controls had European mtDNA haplogroups defined using Agena Biosciences MassARRAY iPlex technology. 39 unique mtDNA variants were genotyped and mtDNA haplogroups were assigned to mitochondrial phylogeny. Striatal dopaminergic degeneration, neuronal loss, and Lewy body counts were also assessed in different brain regions in LBD-hDLB cases. Logistic regression models adjusted for age and sex were used to assess associations between mtDNA haplogroups and risk of DLB or LBD-hDLB versus controls in a case-control analysis. Additional appropriate regression models, adjusted for age at death and sex, assessed associations of haplogroups with each different neuropathological outcome measure. No mtDNA haplogroups were significantly associated with DLB or LBD-hDLB risk after Bonferroni correction.Haplogroup H suggests a nominally significant reduced risk of DLB (OR=0.61, P=0.006) but no association of LBD-hDLB (OR=0.87, P=0.34). The haplogroup H observation in DLB was consistent after additionally adjusting for the number of APOE ε4 alleles (OR=0.59, P=0.004). Haplogroup H also showed a suggestive association with reduced ventrolateral substantia nigra neuronal loss (OR=0.44, P=0.033). Mitochondrial haplogroup H may be protective against DLB risk and neuronal loss in substantia nigra regions in LBD-hDLB cases but further validation is warranted.

PMID:35836284 | DOI:10.1186/s40478-022-01399-4