Tag: pubmed

Skin Res Technol. 2021 Dec 19. doi: 10.1111/srt.13121. Online ahead of print.

ABSTRACT

BACKGROUND: The similar visual appearance of high-risk basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) may cause confusion for diagnosis. High-frequency ultrasound (HFUS) may provide additional intralesional information and thus help to distinguish them.

METHOD: In this retrospective study, we analyzed the clinical characteristics, HFUS grayscale, and color Doppler flow imaging (CDFI) features of pathologically confirmed high-risk BCC and cSCC lesions (n = 65 vs n = 68). Subsequently, discrimination models based on the significant HFUS features were established.

RESULTS: Between high-risk BCC and cSCC lesions, the HFUS grayscale features of the lesion size (10.0 mm vs 17.4 mm), thickness (3.1 mm vs 5.9 mm), internal hyperechoic spots (80.0% vs 23.5%), and posterior acoustic shadowing (16.9% vs 66.2%) were statistically different (all p < 0.001). As for the CDFI features, high-risk BCC lesions mainly appeared as pattern II (47.7%), while cSCC lesions mainly appeared as pattern III (66.2%). Based on the above five features, an optimal discrimination model was established with a sensitivity of 91.2%, a specificity of 87.7%, and an accuracy of 89.5%.

CONCLUSION: HFUS features, including size, thickness, internal hyperechoic spots, posterior acoustic shadowing, and Doppler vascularity pattern, are useful for differential diagnosis between high-risk BCC and cSCC.

PMID:34923684 | DOI:10.1111/srt.13121

Oral Dis. 2021 Dec 18. doi: 10.1111/odi.14109. Online ahead of print.

ABSTRACT

INTRODUCTION: Orofacial clefts (OFCs) are common craniofacial birth defects with heterogeneous phenotype and etiology. Geneticists have applied nearly every available method and technology to further our understanding of the genetic architectures of OFCs.

OBJECTIVE: This review describes the evidence for a genetic etiology in OFCs, statistical genetic approaches employed to identify genetic causes, and how the results have shaped our current understanding of the genetic architectures of syndromic and nonsyndromic OFCs.

CONCLUSION: There has been rapid progress towards elucidating the genetic architectures of OFCs due to the availability of large collections of DNA samples from cases, controls, and families with OFCs and the consistent adoption of new methodologies and novel statistical approaches as they are developed. Genetic studies have identified rare and common variants influencing risk of OFCs in both Mendelian and complex forms of OFCs, blurring the distinctions traditional categories used in genetic studies and clinical medicine.

PMID:34923716 | DOI:10.1111/odi.14109

Scand J Med Sci Sports. 2021 Dec 18. doi: 10.1111/sms.14117. Online ahead of print.

ABSTRACT

Heart rate (HR) responses to maximal exercise are commonly used for the prescription of training intensities in pulmonary rehabilitation. Those intensities are usually based on fixed percentages of peak HR (HRpeak), heart rate reserve (HRR), or peak work load (Wpeak), and rarely on HRs at the individual ventilatory thresholds (VT1 and VT2) derived from cardiopulmonary exercise testing (CPET). For patients suffering from interstitial lung disease (ILD), data on cardiorespiratory responses to CPET are scarce. Thus, the aim of this study was to record cardiorespiratory responses to CPET and to compare fixed HR percentages with HRs at VT1 and VT2 in ILD patients. A total of 120 subjects, 80 ILD patients and 40 healthy controls, underwent a symptom-limited CPET. From the ILD patient, 32 suffered from idiopathic pulmonary fibrosis (IPF), 37 from connective tissue disease (CTD) and 11 from sarcoidosis. HRs at fixed percentages, i.e., at 70%HRpeak, at 70%Wpeak and at 60%HRR were significantly lower in the ILD patients compared to the control group (p-values: 0.001, 0.044, and 0.011). Large percentages of HR values at 70%Wpeak and 60%HRR ranged between the HRs at VT1 and VT2 in ILD subgroups and controls as well. HRs at 70%HRpeak were lower than HRs at VT1 in 66% of the IPF patients, 54% of the CTD patients and 55% of patients with sarcoidosis compared to 18% in the control group. Our findings demonstrate a considerable scattering of fixed HR percentages compared to HRs at the individual VTs derived from CPET in ILD patients. These findings may provide valuable information for the prescription of exercise intensity in pulmonary rehabilitation of ILD patients.

PMID:34923682 | DOI:10.1111/sms.14117

Bull Math Biol. 2021 Dec 18;84(1):17. doi: 10.1007/s11538-021-00975-4.

ABSTRACT

In ecological systems, the hydra effect is an increase in population size caused by an increase in mortality. This seemingly counterintuitive effect has been observed in several populations, including fish, blowflies, snails and plants, and has been modeled in both continuous and discrete time. A similar effect induced by disease has recently been observed empirically. Here we present theoretical and simulation results for an infectious disease-induced hydra effect, namely conditions under which the total population size, composed of those that are infectious as well as those that are susceptible, at an endemic equilibrium is greater than the population size at the disease-free equilibrium. (For an endemic k-cycle, this can be similarly defined using the average population.) We find this disease-induced hydra effect occurs when the intra-specific competition is strong and disease infection sufficiently inhibits the reproductive output of infected individuals. For our continuous time model, we give a necessary and sufficient condition for a disease-induced hydra effect. This condition requires overcompensatory recruitment. With a discrete time model, we show there is no disease-induced hydra effect without overcompensatory recruitment. We illustrate by simulations that a disease-induced hydra effect may occur with Ricker recruitment when the endemic system converges to either a fixed equilibrium or a 2-cycle.

PMID:34923617 | DOI:10.1007/s11538-021-00975-4

Diabet Med. 2021 Dec 19:e14771. doi: 10.1111/dme.14771. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: In persons with type 1 diabetes, the risk of cancer remains controversial. We wanted to examine the excess risk of cancer in a large population-based cohort diagnosed with type 1 diabetes before 15 years of age.

STUDY POPULATION AND METHODS: From July 1, 1977 to December 31, 2013, we prospectively and on a national scale included 18,724 persons (53% men) with childhood-onset type 1 diabetes. For each person with type 1 diabetes, we selected four referents, matched for date at birth and municipality of living at the time when the case developed diabetes. Cases and referents were linked to national registers of cancer and of cause of death.

RESULTS: A total of 125 persons (61 % women) with diabetes had 135 different cancers, all diagnosed after the diabetes diagnosis. The median duration from diabetes diagnosis to first cancer diagnosis was 19 years (interquartile range 10, 26). The median age at cancer diagnosis in the diabetes group was 28 years (interquartile range 20, 35). The overall standardized incidence ratio (95%), using the Swedish general population as referents for women with diabetes was 1.28 (1.02, 1.58) and when comparing women with diabetes with matched referents, we found a hazard ratio of 1.42 (1.10, 1.85). No elevated risk was seen for men. Cancers of the breast and testis were the most common types in women and men, respectively.

CONCLUSIONS: Women with childhood-onset type 1 diabetes had a small but significantly elevated risk of cancer. No such tendency was seen for men. The reason behind this is unclear.

PMID:34923678 | DOI:10.1111/dme.14771

Metabolomics. 2021 Dec 19;18(1):4. doi: 10.1007/s11306-021-01863-7.

NO ABSTRACT

PMID:34923607 | DOI:10.1007/s11306-021-01863-7

Anal Bioanal Chem. 2021 Dec 18. doi: 10.1007/s00216-021-03819-1. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is the most common form of dementia caused by a progressive loss of neurons from different regions of the brain. This multifactorial pathophysiology has been widely characterized by neuroinflammation, extensive oxidative damage, synaptic loss, and neuronal cell death. In this sense, the design of multi-target strategies to prevent or delay its progression is a challenging goal. In the present work, different in vitro assays including antioxidant, anti-inflammatory, and anti-cholinergic activities of a carotenoid-enriched extract from Dunaliella salina microalgae obtained by supercritical fluid extraction are studied. Moreover, its potential neuroprotective effect in the human neuron-like SH-SY5Y cell model against remarkable hallmarks of AD was also evaluated. In parallel, a comprehensive metabolomics study based on the use of charged-surface hybrid chromatography (CSH) and hydrophilic interaction liquid chromatography (HILIC) coupled to high-resolution tandem mass spectrometry (Q-TOF MS/MS) was applied to evaluate the effects of the extract on the metabolism of the treated cells. The use of advanced bioinformatics and statistical tools allowed the identification of more than 314 metabolites in SH-SY5Y cells, of which a great number of phosphatidylcholines, triacylglycerols, and fatty acids were significantly increased, while several phosphatidylglycerols were decreased, compared to controls. These lipidomic changes in cells along with the possible role exerted by carotenoids and other minor compounds on the cell membrane might explain the observed neuroprotective effect of the D. salina extract. However, future experiments using in vivo models to corroborate this hypothesis must be carried out.

PMID:34923590 | DOI:10.1007/s00216-021-03819-1

Int Urol Nephrol. 2021 Dec 19. doi: 10.1007/s11255-021-03091-3. Online ahead of print.

ABSTRACT

PURPOSE: It has been proved that the gut microbiome is altered in patients with chronic kidney disease. This contributes to chronic inflammation and increases cardiovascular risk and mortality, especially in those undergoing hemodialysis. Phosphate binders may potentially induce changes in their microbiome. This trial aimed to compare the changes in the gut microbiome of hemodialysis patients treated with calcium acetate to those treated with sucroferric oxyhydroxide.

METHODS: Twelve hemodialysis patients were distributed to receive calcium acetate or sucroferric oxyhydroxide for 5 months. Blood samples (for biochemical analysis) and stool samples (for microbiome analysis) were collected at baseline, 4, 12, and 20 weeks after treatment initiation. Fecal DNA was extracted and a 16S rRNA sequencing library was constructed targeting the V3 and V4 hypervariable regions.

RESULTS: Regarding clinical variables and laboratory parameters, no statistically significant differences were observed between calcium acetate or sucroferric oxyhydroxide groups. When analyzing stool samples, we found that all patients were different (p = 0.001) among themselves and these differences were kept along the 20 weeks of treatment. The clustering analysis in microbial profiles grouped the samples of the same patient independently of the treatment followed and the stage of the treatment.

CONCLUSION: These results suggest that a 5-month treatment with either calcium acetate or sucroferric oxyhydroxide did not modify baseline diversity or baseline bacterial composition in hemodialysis patients, also about the high-variability profiles of the gut microbiome found among these patients.

PMID:34923600 | DOI:10.1007/s11255-021-03091-3

Age Ageing. 2021 Dec 6:afab233. doi: 10.1093/ageing/afab233. Online ahead of print.

ABSTRACT

OBJECTIVE: to develop a user-friendly prediction tool of 1-year mortality for patients with hip fracture, in order to guide clinicians and patients on appropriate targeted preventive measures.

DESIGN: population-based cohort study from 2011 to 2017 using nationwide data from the Danish Hip Fracture Registry.

SUBJECTS: a total of 28,791 patients age 65 and above undergoing surgery for a first-time hip fracture.

METHODS: patient-related prognostic factors at the time of admission were assessed as potential predictors: Nursing home residency, comorbidity (Charlson Comorbidity Index [CCI] Score), frailty (Hospital Frailty Risk Score), basic mobility (Cumulated Ambulation Score), atrial fibrillation, fracture type, body mass index (BMI), age and sex. Association with 1-year mortality examined by determining the cumulative incidence, applying univariable logistic regression and assessing discrimination (area under the receiver operating characteristics curve [AUROC]). The final model (logistic regression) was utilised on a development cohort (70% of patients). Discrimination and calibration were assessed on the validation cohort (remaining 30% of patients).

RESULTS: all predictors showed an association with 1-year mortality, but discrimination was moderate. The final model included nursing home residency, CCI Score, Cumulated Ambulation Score, BMI and age. It had an acceptable discrimination (AUROC 0.74) and calibration, and predicted 1-year mortality risk spanning from 5 to 91% depending on the combination of predictors in the individual patient.

CONCLUSIONS: using information obtainable at the time of admission, 1-year mortality among patients with hip fracture can be predicted. We present a user-friendly chart for daily clinical practice and provide new insight regarding the interplay between prognostic factors.

PMID:34923589 | DOI:10.1093/ageing/afab233

Eur J Anaesthesiol. 2021 Dec 17. doi: 10.1097/EJA.0000000000001649. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative emergence agitation remains a significant challenge in paediatric anaesthesia. Although short-lived, it may cause harm to the patient and negative experiences for all. Differentiating agitation, delirium and pain is difficult. Electroencephalography allows precise titration of anaesthetic depth, and heart rate variability monitoring permits immediate intervention regarding nociception and pain. We examined if one of these measures could be used to reduce postoperative agitation in an unselected paediatric day surgical population.

OBJECTIVE: The primary outcome was postoperative agitation with a Richmond Agitation-Sedation Scale greater than 0. Secondary outcomes were: length of stay, postoperative nausea and vomiting, fentanyl and propofol consumption, pain scores and use of postoperative analgesics.

DESIGN: A randomised, single-blinded study constituting children aged 1 to 6 years, undergoing minor general day surgical procedures.

SETTING: Paediatric day surgical department 29th March 2019 to 12th June 2020.

PATIENTS: Ninety-eight children (ASA 1 or 2) were enrolled, and 93 children were included in the final analysis.

INTERVENTIONS: Children received standard monitoring (n=31), standard monitoring plus either Narcotrend (n=31), or Anaesthesia Nociception Index monitoring (n=31). Sevoflurane or fentanyl was titrated immediately according to monitor thresholds.

RESULTS: Kaplan-Meier analysis yielded a statistically significant difference between the groups (P = 0.016) with the lowest agitation levels in the Anaesthesia Nociception Index group, intermediate levels in the control group and the highest agitation levels in the Narcotrend monitored group. Intergroup pairwise comparison however, showed no difference. The Anaesthesia Nocioception Index group received slightly more fentanyl (P = 0.277). The control group patients had the highest pain scores despite receiving more caudal blocks and the Narcotrend group had more sevoflurane adjustments. Other secondary outcomes were comparable.

CONCLUSION: Children in the Anaesthesia Nociception Index group were the least agitated with the highest fentanyl doses, without increasing the length of stay in the PACU or postoperative nausea and vomiting.

CLINICAL REGISTRATION: The study was registered in RedCAP online trial database 1/11/2018 trial registration nr. OP720. https://open.rsyd.dk/OpenProjects/openProject.jsp?openNo=720&lang=da.

PMID:34923564 | DOI:10.1097/EJA.0000000000001649