Tag: pubmed

Am J Transplant. 2021 Dec 25. doi: 10.1111/ajt.16934. Online ahead of print.

ABSTRACT

Kidney transplantation (KT) experts did not support the use of subjective unintentional weight loss to measure shrinking in the Physical Frailty Phenotype (PFP); a clinically feasible and predictive measure of shrinking is needed. To test whether unintentional weight loss could be replaced by an assessment of sarcopenia using existing CT scans, we performed a prospective cohort study of adult KT recipients with original PFP (oPFP) measured at admission (12/2008-2/2020). We ascertained sarcopenia by calculating skeletal muscle index from available, clinically obtained CTs within 1-year pre-KT (male<50cm² /m² ; female<39cm² /m² ) and combined it with the original 4 components to determine new PFP (nPFP) scores. Frailty was classified by frailty score: 0:non-frail;1-2:pre-frail;≥3:frail. Mortality and graft loss hazard ratios (HRs) were estimated using adjusted Cox proportional hazard models. Model discrimination was quantified using Harrell’s C-statistic. Among 1,113 recipients, 18.6% and 17.1% were frail by oPFP and nPFP, respectively. Compared to non-frail recipients, frail patients by either PFP had higher risks of mortality (oPFP HR=1.67,95%CI:1.07-2.62,C=0.710; nPFP HR=1.68,95%CI:1.06-2.66,C=0.710) and graft loss (oPFP HR=1.67,95%CI:1.17-2.40,C=0.631; nPFP HR=1.66,95%CI:1.15-2.40,C=0.634) with similar discriminations. oPFP and nPFP are equally useful in risk prediction for KT recipients; oPFP may aid in screening patients for pre-KT interventions, while nPFP may assist in nuanced clinical decision-making.

PMID:34953170 | DOI:10.1111/ajt.16934

J Magn Reson Imaging. 2021 Dec 25. doi: 10.1002/jmri.28040. Online ahead of print.

ABSTRACT

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide. It is subdivided into nonalcoholic fatty liver (NAFL) and the more aggressive form, nonalcoholic steatohepatitis (NASH), which carries a higher risk of developing fibrosis and cirrhosis. There is currently no reliable non-invasive method for differentiating NASH from NAFL.

PURPOSE: To investigate the ability of magnetic resonance imaging (MRI)-based imaging biomarkers to diagnose NASH and moderate fibrosis as well as assess their repeatability.

STUDY TYPE: Prospective.

SUBJECTS: Sixty-eight participants (41% women) with biopsy-proven NAFLD (53 NASH and 15 NAFL). Thirty participants underwent a second MRI in order to assess repeatability.

FIELD STRENGTH/SEQUENCE: 3.0 T; MR elastography (MRE) (a spin-echo echo-planar imaging [SE-EPI] sequence with motion-encoding gradients), MR proton density fat fraction (PDFF) and R2* mapping (a multi-echo three-dimensional gradient-echo sequence), T1 mapping (a single-point saturation-recovery technique), and diffusion-weighted imaging (SE-EPI sequence).

ASSESSMENT: Quantitative MRI measurements were obtained and assessed alone and in combination with biochemical markers (cytokeratin-18 [CK18] M30, alanine transaminase [ALT], and aspartate transaminase [AST]) using logistic regression models. Models that could differentiate between NASH and NAFL and between moderate to advanced fibrosis (F2-4) and no or mild fibrosis (F0-1), based on the histopathological results, were identified.

STATISTICAL TESTS: Independent samples t-test, Pearson’s chi-squared test, area under the receiver operating characteristic curve (AUROC), Spearman’s correlation, intra-individual coefficient of variation, and intraclass correlation coefficient (ICC). Statistical significance was set at P < 0.05.

RESULTS: There was a significant difference between the NASH and NAFL groups with liver stiffness assessed with MRE, CK18 M30, and ALT, with an AUROC of 0.74, 0.76, and 0.70, respectively. Both MRE and PDFF contributed significantly to a bivariate model for diagnosing NASH (AUROC = 0.84). MRE could significantly differentiate between F2-4 and F0-1 (AUROC = 0.74). A model combining MRE with AST improved the diagnosis of F2-4 (AUROC = 0.83). The ICC for repeatability was 0.94 and 0.99 for MRE and PDFF, respectively.

DATA CONCLUSION: MRE can potentially diagnose NASH and differentiate between fibrosis stages. Combining MRE with PDFF improves the diagnosis of NASH.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

PMID:34953171 | DOI:10.1002/jmri.28040

J Magn Reson Imaging. 2021 Dec 25. doi: 10.1002/jmri.28044. Online ahead of print.

ABSTRACT

BACKGROUND: Gadobutrol (GB) and gadoterate meglumine (GM) are contrast agents used for contrast-enhanced magnetic resonance angiography (CEMRA). Supraaortic vasculature (SAV) CEMRAs are used to evaluate stroke risk and neurologic symptoms. There is a need to compare the SAV CEMRA image quality obtained with GB and GM.

PURPOSE: To intra-individually compare MRA images obtained with equimolar GB and GM at 1.5 T in the SAV.

STUDY TYPE: Prospective, crossover.

POPULATION: Twenty-eight subjects (54 ± 13 years; 17 female).

FIELD STRENGTH/SEQUENCE: 1.5 T; three-dimensional (3D) gradient recalled echo.

ASSESSMENT: Quantitative image quality was measured by normalized signal intensity (SI_n ) [SI_n = SI blood/SD blood] and contrast ratio (CR) [CR = SI blood/SI muscle], determined by an observer (JWC) with 1 year of vascular imaging experience. Three radiologists (AS, PA, and MU) with (5, 5, and 6 years of) vascular imaging experience evaluated image quality by Likert-scale ratings (of image impression, wall conspicuity, and artifact absence).

STATISTICAL TESTS: SI_n and CR were compared with paired t-tests or Wilcoxon signed-rank tests and Bland-Altman plots. Qualitative ratings were compared with Wilcoxon signed-rank test.

RESULTS: No significant difference in SI_n was found between GB and GM. CRs with GB were significantly higher than GM at the right common carotid (6.9 ± 2.5 vs. 4.8 ± 1), left internal carotid (7.3 ± 2 vs. 4.4 ± 1.2), right internal carotid (7.7 ± 2.2 vs. 5 ± 1.1), and left vertebral (6.6 ± 2.2 vs. 4.5 ± 1.1) arteries. Bland-Altman plots showed relatively greater differences between GB and GM at higher CRs and SI_n s. GM showed significantly higher artifact than GB (3.56 ± 0.52 vs. 3.36 ± 0.46) and significantly lower overall image quality (10.73 ± 1.45 vs. 11.26 ± 1.58) at the left vertebral artery.

DATA CONCLUSION: At 1.5 T and equimolar demonstration, GB (0.1 mL/kg, i.e., 0.1 mmol/kg) showed higher CRs in the SAV compared to GM (0.2 mL/kg, i.e., 0.1 mmol/kg) at most vessels. Subjective image quality was not significantly different between the two agents for most vessels.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

PMID:34953154 | DOI:10.1002/jmri.28044

Transbound Emerg Dis. 2021 Dec 25. doi: 10.1111/tbed.14441. Online ahead of print.

ABSTRACT

In northern Illinois, chronic wasting disease (CWD) was first identified in free-ranging white-tailed deer (Odocoileus virginianus; hereafter referred to as “deer”) in 2002. To reduce CWD transmission rates in Illinois, wildlife biologists have conducted locally-focused culling of deer since 2003 in areas where CWD has been detected. We used retrospective spatial, temporal, and space-time scan statistical models to identify areas and periods where culling removed higher than expected numbers of CWD-positive deer. We included 490 Public Land Survey “sections” (∼2.59 km² ) from 15 northern Illinois counties in which at least one deer tested positive for CWD between 2003 and 2020. A negative binomial regression model compared the proportion of CWD positive cases removed from sections with at least one CWD case detected in the previous years, “local area 1 (L1),” to the proportion of CWD cases in adjacent sections -L2, L3, and L4- designated by their increasing distance from L1. Of the 14,661 deer removed and tested via culling, 325 (2.22 %) were CWD-positive. A single temporal CWD cluster occurred in 2020. Three spatial clusters were identified, with a primary cluster located at the border of Boone and Winnebago counties. Four space-time clusters were identified with a primary cluster in the northern portion of the study area from 2003 to 2005 that overlapped with the spatial cluster. The proportion of CWD cases removed from L1 (3.92, 95% CI, 2.56- 6.01) and L2 (2.32, 95% CI, 1.50- 3.59) were significantly higher compared to L3. Focusing culling efforts on accessible properties closest to L1 areas results in more CWD-infected deer being removed, which highlights the value of collaborations among landowners, hunters, and wildlife management agencies to control CWD. Continuous evaluation and updating of the culling and surveillance programs are essential to mitigate the health burden of CWD on deer populations in Illinois. This article is protected by copyright. All rights reserved.

PMID:34953169 | DOI:10.1111/tbed.14441

J Texture Stud. 2021 Dec 25. doi: 10.1111/jtxs.12658. Online ahead of print.

ABSTRACT

This study was undertaken to determine the correlation between instrumental and sensory evaluation on texture modified carrot puree. Texture modified foods (TMF) are prescribed to dysphagia individuals to aid in the oral manipulation and facilitate swallowing of food. There is a lack of correlation between instrumental measurements and sensory attributes on TMF. Understanding this correlation will aid in the formulation of safe foods with desired sensory properties for dysphagia patients. Instrumental measurements of carrot purees were performed by back extrusion method using a texture analyser and the attributes obtained were firmness, consistency, cohesiveness and adhesiveness. Quantitative Descriptive Analysis (QDA) with eight trained panellists was employed to characterize the texture of the carrot puree based on seven sensory attributes: Firmness, viscous, adhesive (mouth), smoothness, adhesive (throat), rate of breakdown, difficulty to swallow. Five thickeners, namely gellan gum, xanthan gum, Suberakaze, UNI-PURE® Dys-sperse instant thickener, ULTRA-SPERSE® M Starch were evaluated against carrot puree without any thickener as control. The correlation results obtained from texture analysis and sensory evaluation were statistically significant (p < 0.05). The firmness attributes from instrumental and sensory results were positively correlated. The consistency parameter was positively correlated to sensory attribute viscous and negatively correlated to smoothness. The sensory attribute rate of breakdown was negatively correlated to instrumental parameter of cohesiveness. Lastly, instrumental adhesiveness was positively correlated to sensory attributes adhesive to mouth and throat, and difficulty to swallow. The correlation results showed a well-designed instrumental technique can be used to understand the impact of thickeners on TMF for dysphagia subjects. This article is protected by copyright. All rights reserved.

PMID:34953142 | DOI:10.1111/jtxs.12658

Laryngoscope. 2021 Dec 25. doi: 10.1002/lary.30000. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: Psychosocial distress is common among patients with head and neck cancer (HNC) and is associated with poorer quality of life and clinical outcomes. Despite these risks, distress screening is not widely implemented in HNC care. In this study, we investigated the prevalence of psychosocial distress and its related factors in routine care of patients with HNC.

METHODS: Data from medical records between September 2017 and March 2020 were analyzed. Psychosocial distress was measured by the National Comprehensive Cancer Network’s Distress Thermometer (DT), and a modified HNC-specific problem list; depression and anxiety were assessed using the Patient Health Questionnaire-4. Descriptive statistics and logistic regression were conducted to report prevalence of distress, depression and anxiety, and factors associated with clinical distress. Implementation outcomes, including rates of referrals and follow-up for distressed patients, are also reported.

RESULTS: Two hundred and eighty seven HNC patients completed the questionnaire (age 64.3 ± 14.9 years), with a mean distress score of 4.51 ± 3.35. Of those, 57% (n = 163) reported clinical distress (DT ≥ 4). Pain (odds ratio [OR] = 3.31, 95% CI = 1.75-6.26), fatigue (OR = 2.43, 95% CI = 1.1.7-5.05), anxiety (OR = 1.63, 95% CI = 1.30-2.05), and depression (OR = 1.51, 95% CI = 1.04-2.18) were significantly associated with clinical distress (P < .05). Of patients identified as distressed, 79% received same-day psychosocial evaluation.

CONCLUSIONS: Clinical distress was identified in 57% of patients who completed the questionnaire, suggesting that an ultra-brief psychosocial screening protocol can be implemented in routine ambulatory oncology care, and identifies patients whose distress might otherwise go unrecognized.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2021.

PMID:34953151 | DOI:10.1002/lary.30000

Ann Parasitol. 2021;67(3):505-513. doi: 10.17420/ap6703.364.

ABSTRACT

The objective of this study was to investigate the prevalence of intestinal parasites and the possible association between irritable bowel syndrome (IBS) and parasitic infections. The study included 100 IBS patients and 100 healthy control subjects. All study subjects filled a structured questionnaire, which covered demographic information and clinical data. Fresh stool samples were collected from patients and control subjects and processed during the same day of collection. Iodine wet mounts and trichrome stained smears prepared from fresh stool and sediment concentrates were microscopically examined for intestinal parasites. Patients attended private gastroenterology clinics and those found to have IBS (45 males and 55 females) were then selected in this study. The healthy subjects (50 males, 50 females) were recruited as controls. In the IBS patients, Blastocystis sp. was detected in 57% and Giardia sp. cysts were observed in 43%. In the control subjects, Blastocystis sp. was detected in 12% and Giardia sp. cysts were observed in 20%. These parasites were found either alone or with other parasites. Only the differences in the presence of Blastocystis (P=0.0001) and Giardia (P=0.0006) between IBS patients and controls were statistically significant. Abdominal pain and blotting were the leading symptoms in IBS patients and controls. Prevalence of Blastocystis and Giardia was higher in IBS patients than in controls. These parasites are likely to have a role in the pathogenesis of IBS. The findings of the study support a possible link between parasitic infections and IBS.

PMID:34953126 | DOI:10.17420/ap6703.364

Ann Parasitol. 2021;67(3):357-366. doi: 10.17420/ap6703.351.

ABSTRACT

The aim of the present study is to systematically review the studies on Neospora caninum infection in aborted bovine fetuses in Iran. Search for all published reports on N. caninum in Iran was performed from inception until January 2020. Major English (PubMed, Scopus and Science Direct) and Persian (SID, Iranmedex, and Magiran) electronic database sources were used. Finally, 16 articles were assessed for eligibility and 12 articles comprising 20 independent studies were selected for inclusion in the meta-analysis. Due to the statistically significant heterogeneity (Q=149.12, df=19, P<0.001 and I2=87.26), the random effect model was used for meta-analysis. Prevalence of N. caninum infection in 1239 aborted bovine fetuses with 351 positive ones was 34.8% (95% CI: 26.5–44.0%). Sample size was categorized as < 50 and ≥ 50 and subgroup meta-analysis was performed to compensate for the loss of precision due to inclusion of small size studies. The result showed that overall prevalence of infection in the latter group (23.1%) is significantly lower than in the first category (45.7%). It may be suggested that the subgroup with large sample size would be more precise and conservative approximation of the infection at the country level. The present meta-analysis confirms the previous findings regarding the importance of N. caninum as a major abortion agent in cattle industry in Iran and the need for appropriate action toward prevention and control of this parasite.

PMID:34953113 | DOI:10.17420/ap6703.351

Ann Parasitol. 2021;67(3):445-453. doi: 10.17420/ap6703.357.

ABSTRACT

Hydatidosis is a disease caused by the larval stage of Echinococcus granulosus, which has great importance in medicine and veterinary medicine. Protoscolices (PSCs) of fertile hydatid cysts play a critical role in secondary echinococcosis after surgery. Fertile cysts were acquired from infected sheep at the local municipal abattoir in Ahvaz, southwest of Iran. PSCs were obtained aseptically and transferred to 10 different culture media and kept at 4°C and 37°C to determine the duration of PSCs’ survival. Then, 2000 live PSCs from each of the culture media were injected into the peritoneal cavity of BALB/c mice. After five months, the mice were evaluated in terms of cyst number, size, and weight. The highest PSCs survival time at 4°C was related to RPMI-1640 medium and cyst fluid for 50 and 45 days, respectively. Also, at 37°C, the longest survival time of PSCs was related to cyst fluid and RPMI-1640 media for 30 and 29 days, respectively. The highest level of infection and median cyst number was observed in mice received PSCs from the RPMI-1640 medium at 4°C, and the highest level of infection in mice at 37°C was related to the DMEM low glucose (L) medium. The current study indicated that 4°C was a more suitable temperature for in vitro storage of live PSCs. The maximum amount of infection was observed in mice received PSCs from the RPMI-1640 medium at 4°C. The present study is the first attempt to compare the ability of PSCs to generate hydatid cysts in mice after being cultured in different media and at various temperatures.

PMID:34953119 | DOI:10.17420/ap6703.357

J Food Sci. 2021 Dec 25. doi: 10.1111/1750-3841.16013. Online ahead of print.

ABSTRACT

The pericarp of Citrus reticulata “Chachi” (CRCP) is used as nutritional food and traditional medicine in China, usually harvested at three periods, namely, immature (CRCP-G1), semi-mature (CRCP-G2), and fully mature (CRCP-G3). Traditionally, if the CRCP is stored for a longer period, then the quality will be better. In this study, the dynamic variation of phytochemical and volatile compounds was profiled in the same batches of CRCP during 2 years of storage. Results illustrated that most of the phytochemical compounds showed a decreasing trend during storage, that is, total flavonoids, total phenolic acids, hesperidin, 3,5,6,7,8,3′,4′-heptamethoxyflavone, 5-hydroxy-6,7,8,3′,4′-pentamethoxyflavone, synephrine, and limonin. The ferulic acid increased significantly, whereas no significant changes were observed in the total polymethoxyflavones, nobiletin, and tangeretin after 2 years of storage. In addition, we found that the extraction yield of volatile oil decreased significantly in CRCP-G1 during storage, and the herb odors were enhanced with the increase of phenols and esters. No significant difference in the extraction yield of volatile oil of CRCP-G2 and CRCP-G3 was found after 2 years of storage, but the citrus-like notes were increased with the promoted generation of alkenes. In particular, the multivariate statistical analysis indicated that 7 volatiles showed a higher level after 1 year of storage, whereas 11 volatiles decreased and 4 volatiles increased after 2 years of storage, respectively. This study could show the early aging mechanism of CRCP harvested at different periods and provide a scientific guidance in the storage of CRCP. PRACTICAL APPLICATION: This study indicated a comprehensive method for rapid analysis of phytochemical and volatile compounds in pericarp of Citrus reticulata ”Chachi” (Rutaceae) (CRCP) harvested at different periods during 2 years of storage. The results obtained from this study would be valuable for revealing the early aging mechanism and sustainable storage of CRCP.

PMID:34953087 | DOI:10.1111/1750-3841.16013