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Dietary supplements in hypothyroidism

Acta Sci Pol Technol Aliment. 2021 Oct-Dec;20(4):375-381. doi: 10.17306/J.AFS.0985.

ABSTRACT

BACKGROUND: According to Statistics Poland (GUS, 2021), 15.8% of women and 2.5% of men suffer from thyroid disease. Although pharmacotherapy is the primary treatment, there is evidence that some vitamins and minerals can alleviate the symptoms of thyroid disease. A well-balanced and varied diet should cover the individual demand for energy and all necessary nutrients. However, dietary supplements are prevalent in Poland. This study aims to evaluate the frequency and reasons behind dietary supplementation in patients with hypothyroid diseases.

METHODS: 232 volunteers (203 women and 29 men) from Poland participated in the research. The research was conducted using a questionnaire. Participants were asked to provide information on their diagnosis, clinical manifestations of the disease, their lifestyles, and the use of dietary supplements with the effect on their health.

RESULTS: The medium age of participants was 27 years. Of them, 85% took dietary supplements. The most popular were vitamin D, magnesium, omega-3 acids, selenium, multivitamins, vitamins B, iron, vitamin C, and zinc. In addition, 53% of patients implemented lifestyle changes after a diagnosis of hypothyroidism. There was a correlation between the participants’ age and the willingness to introduce lifestyles modifications: the younger the participants were, the eager they were to introduce modifications (r = −0.243, p = 0.010, 95% CI: −0.410 to −0.060). In addition, there was a correlation between the participants’ age and the willingness to change their diets: the older the participants were, the more eager they were to change diets (r = 0.283, p = 0.003, 95% CI: 0.103–0.445). Patients indicated numerous health benefits of using dietary supplements. The vitamin D and vitamin and mineral complexes were indicated as the most beneficial.

CONCLUSIONS: Dietary supplementation is prevalent in Poland, especially among hypothyroidism patients. Patients take a variety of supplements, claiming that they improve the condition of their skin, nails, memory, and others, which may be controversial. Therefore, it seems advisable to deepen the patients’ supplementation knowledge (via contact with a physician, dietitian, etc.). Furthermore, reliable guidelines on  supplementation for hypothyroidism patients based on clinical trials should be developed.

PMID:34724363 | DOI:10.17306/J.AFS.0985

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Optimization of carrot fermentation conditions in rice bran bed using Lactobacillus plantarum

Acta Sci Pol Technol Aliment. 2021 Oct-Dec;20(4):449-457. doi: 10.17306/J.AFS.0944.

ABSTRACT

BACKGROUND: A statistical model was developed in this study to describe lactic acid production through a fermentation process of carrot in a rice bran bed by Lactobacillus plantarum.

METHODS: Response surface methodology (RSM) based on Box-Behnken design was employed to statistically evaluate and optimize the conditions for maximum lactic acid production.

RESULTS: The significance and interaction of salt concentration, water and initial L. plantarum starter density on final lactic acid content were found. With the use of the developed quadratic model equation, a maximum achieved lactic acid content of 1.35% was obtained in a rice bran bed fermentation process at optimum operating conditions of approximately 2.95% salt, 48.24% water and 2.9 log cfu/g of L. plantarum. After fermentation, the amount of total polyphenol content, antioxidant activity and carbohydrate had increased while the β-carotene in carrot was significantly retained (92.84%).

CONCLUSIONS: The above results could provide a practical basis for the fermentation process in rice bran bed to produce a delicious and reliable product using L. plantarum strain XK 1.4 which could be a significant contribution to the food industry.

PMID:34724368 | DOI:10.17306/J.AFS.0944

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Comparison of efficacy and safety of tranexamic acid mesotherapy versus oral tranexamic acid in patients with melasma undergoing Q-switched fractional 1064-nm Nd:YAG laser: A blinded RCT and follow-up

J Cosmet Dermatol. 2021 Nov 1. doi: 10.1111/jocd.14496. Online ahead of print.

ABSTRACT

BACKGROUND: Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd-Yag fractional 1064 plus microinjection of tranexamic acid versus Nd-Yag fractional 1064 plus oral tranexamic acid in patients with melasma.

MATERIALS AND METHODS: This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2-week intervals. Twenty patients were administered localized microinjections (4 mg/ml) of tranexamic acid and Q-switched 1064 laser every 2 weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250 mg three times a day and Q-switched 1064 laser every 2 weeks per visit.

RESULTS: Twenty-one patients with mean SD 40.52+-4.95 y/o were treated with oral tranexamic acid, and 20 patients with 43.3+-5.87 y/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (p > 0.05). The patients MASI score and ∆E decrease over the study period in both treatments significantly (p < 0.001). However, patient’s MASI score (p = 0.99) and ∆E (p = 0.53) did not differ significant between the two group over the time. Satisfaction (p = 0.41) and complication during the study period (p = 0.09) were not significantly different between the two group.

CONCLUSION: The combination treatment method can be a viable option for Middle Eastern patients having melasma disorder, and tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration. Tranexamic acid can increase the permeability locally by non-invasive methods such as microneedling which is less painful than microinjection and can also increase patient satisfaction. Although the oral method is more tolerable for the patient, it may have systemic side effects, and its combination with Q-switch laser increases its effect regardless of the type of prescription. Therefore, it is recommended to use of this drug topically (cream or lotion) by non-invasive methods like microneedling to reduce pain and laser treatment in future studies.

PMID:34724323 | DOI:10.1111/jocd.14496

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Development and testing of the situational judgement test to measure safety performance of healthcare professionals: An explorative cross-sectional study

Nurs Open. 2021 Nov 1. doi: 10.1002/nop2.1119. Online ahead of print.

ABSTRACT

AIM: To measure safety performance, situational judgement test, which is a method composed of job-related situations, can be used. This study aimed to develop and test its psychometric properties by measuring the safety performance of healthcare professionals in German hospitals.

DESIGN: An explorative cross-sectional study.

METHODS: A team of researchers, nurses and physicians developed seven items, which focus on different safety areas. Descriptive statistics were calculated for each item. Cronbach’s alpha was calculated as an indication of internal consistency. Spearman’s correlation between the items was evaluated as analysis of construct validity. A cross-sectional survey with healthcare professionals in three German hospitals was conducted to test the developed instrument.

RESULTS: A total of 168 healthcare professionals participated (response rate: 39.1%). 70.2% were women, and 38.7%, 33.9%, 15.5% and 11.3% were registered nurses, nurses in training, physicians and other healthcare professionals respectively. The situational judgement test demonstrated an acceptable psychometric performance.

PMID:34724359 | DOI:10.1002/nop2.1119

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Improvement in epistaxis management: the experience of a dedicated hereditary haemorrhagic telangiectasia clinic

ANZ J Surg. 2021 Nov 1. doi: 10.1111/ans.17322. Online ahead of print.

ABSTRACT

BACKGROUND: Hereditary haemorrhagic telangiectasia (HHT) is a rare genetic vascular disorder which is characterised by the development of arteriovenous malformations and telangiectasias. A key clinical manifestation is recurrent epistaxis. This study examined the impact of a dedicated HHT clinic in a major Australian tertiary hospital on epistaxis symptoms and subjective quality of life.

METHODS: A multidisciplinary HHT clinic was established in 2015. All patients satisfied either genetic diagnosis or fulfilled Curacao criteria. A protocol based clinical assessment was performed and a standardised treatment regimen was implemented. Patients completed quality of life and epistaxis severity score (ESS) questionnaires at each review.

RESULTS: Participants of the dedicated clinic included 21 females (58.3%) and 15 males (41.7%), with a mean age of 49.0 ± 24.0 years. The ACVRL1 variant was the most common (n = 20, 55.6%). A statistically significant reduction in epistaxis severity was noted between the baseline and second review (P = 0.02) and was maintained to the third visit (P = 0.015). Patients older than 50 years demonstrate a consistently higher ESS than those less than 50 years old (P = 0.03). This trend is noted throughout the follow up period with the dedicated clinic.

CONCLUSION: The introduction of a multidisciplinary, dedicated HHT clinic to provide enhanced assessment, monitored treatment regimen and greater access to care, resulted in improvement in the management of epistaxis and quality of life in these patients.

PMID:34724318 | DOI:10.1111/ans.17322

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A deep matrix completion method for imputing missing histological data in breast cancer by integrating DCE-MRI radiomics

Med Phys. 2021 Nov 1. doi: 10.1002/mp.15316. Online ahead of print.

ABSTRACT

PURPOSE: Clinical indicators of histological information are important for breast cancer treatment and operational decision making, but these histological data suffer from frequent missing values due to various experimental/clinical reasons. The limited amount of histological information from breast cancer samples impedes the accuracy of data imputation. The purpose of this study was to impute missing histological data, including Ki-67 expression level, luminal A subtype, and histological grade, by integrating tumor radiomics.

METHODS: To this end, a deep matrix completion (DMC) method was proposed for imputing missing histological data using nonmissing features composed of histological and tumor radiomics (termed radiohistological features). DMC finds a latent nonlinear association between radiohistological features across all samples and samples for all the features. Radiomic features of morphologic, statistical and texture features were extracted from dynamic enhanced magnetic imaging (DCE-MRI) inside the tumor. Experiments on missing histological data imputation were performed with a variable number of features and missing data rates. The performance of the DMC method was compared with those of the nonnegative matrix factorization (NMF) and collaborative filtering (MCF)-based data imputation methods. The area under the curve (AUC) was used to assess the performance of missing histological data imputation.

RESULTS: By integrating radiomics from DCE-MRI, the DMC method showed significantly better performance in terms of AUC than that using only histological data. Additionally, DMC using 120 radiomic features showed an optimal prediction performance (AUC = 0.793), which was better than the NMF (AUC = 0.756) and MCF methods (AUC = 0.706; corrected p = 0.001). The DMC method consistently performed better than the NMF and MCF methods with a variable number of radiomic features and missing data rates.

CONCLUSIONS: DMC improves imputation performance by integrating tumor histological and radiomics data. This study transforms latent imaging-scale patterns for interactions with molecular-scale histological information and is promising in the tumor characterization and management of patients. This article is protected by copyright. All rights reserved.

PMID:34724248 | DOI:10.1002/mp.15316

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An improved experimental method for simultaneously isolating hepatocytes and hepatic stellate cells in mouse liver infected with Echinococcus multilocularis

J Clin Lab Anal. 2021 Nov 1:e24084. doi: 10.1002/jcla.24084. Online ahead of print.

ABSTRACT

BACKGROUND: Alveolar echinococcosis (AE) is a zoonotic disease caused by the larval stage of Echinococcus multilocularis parasitizing in the human liver, causing local pathological changes in the liver and manifesting as hyperplasia, liver fibrosis, atrophy, degeneration, and necrosis. Here, we report a method that can simultaneously isolate hepatocytes and hepatic stellate cells (HSCs) from mice infected with Echinococcus multilocularis.

METHODS: A mouse model of AE was established. Hepatocytes and HSCs were isolated from mouse liver using a two-step method combining in situ collagenase perfusion and gradient centrifugation. Expressions of Alb, Desmin, and α-SMA were detected with immunofluorescence to identify the isolated hepatocytes and HSCs.

RESULTS: The viability and purity of hepatocytes and HSCs both reached 90% or above. For hepatocytes, clear cell boundaries were observed, and the nuclei were round or oval, with clear nucleoli. There was a homogeneous distribution of the hepatocyte marker Alb in the cytoplasm of hepatocytes. Lipid droplets and Desmin expression were observed in the cytoplasm of freshly isolated HSCs. During the activation of HSCs, the lipid droplets gradually decreased and disappeared with a high expression of α-SMA.

CONCLUSION: Hepatocytes and HSCs are simultaneously isolated. This may provide a research tool to investigate the interaction between hepatocytes and HSCs and to investigate the mechanism of Echinococcus multilocularis infection-induced liver pathological changes.

PMID:34724252 | DOI:10.1002/jcla.24084

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Citrus-Gene Interaction and Melanoma Risk in the UK Biobank

Int J Cancer. 2021 Nov 1. doi: 10.1002/ijc.33862. Online ahead of print.

ABSTRACT

High citrus consumption may increase melanoma risk; however, little is known about the biological mechanisms of this association, or whether it is modified by genetic variants. We conducted a genome-wide analysis of gene-citrus consumption interactions on melanoma risk among 1,563 melanoma cases and 193,296 controls from the UK Biobank. Both the 2-degrees-of-freedom (df) joint test of genetic main effect and gene-environment (G-E) interaction and the standard 1-df G-E interaction test were performed. Three index SNPs (lowest p-value SNP among highly correlated variants [r2 >0.6]) were identified from among the 365 genome-wide significant 2-df test results (rs183783391 on chromosome 3 [MITF], rs869329 on chromosome 9 [MTAP], rs11446223 on chromosome 16 [DEF8]). Although all three were statistically significant for the 2-df test (4.25e-08, 1.98e-10, and 4.93e-13, respectively), none showed evidence of interaction according to the 1-df test (p=0.73, 0.24, 0.12, respectively). Eight non-index, 2-df test significant SNPs on chromosome 16 were significant (p<.05) according to the 1-df test, providing evidence of citrus-gene interaction. Seven of these SNPs were mapped to AFG3L1P (rs199600347, rs111822773, rs113178244, rs3803683, rs73283867, rs78800020, rs73283871), and one SNP was mapped to GAS8 (rs74583214). We identified several genetic loci that may elucidate the association between citrus consumption and melanoma risk. Further studies are needed to confirm these findings. This article is protected by copyright. All rights reserved.

PMID:34724200 | DOI:10.1002/ijc.33862

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The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial

Laryngoscope. 2021 Nov 1. doi: 10.1002/lary.29935. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the effect of povidone-iodine (PVP-I) nasal sprays on nasopharyngeal (NP) viral load as assessed by cycle threshold on quantitative polymerase chain reaction (qPCR) of SARS-CoV-2 in outpatients.

STUDY DESIGN: Three arm, triple blinded, randomized, placebo-controlled clinical trial.

METHODS: Participants were randomized within 5 days of testing positive for COVID-19 to receive nasal sprays containing either placebo (0.9% saline), 0.5% PVP-I, or 2.0% PVP-I. NP swabs for qPCR analysis were taken at baseline, 1-hour post-PVP-I spray (2 sprays/nostril), and 3 days post-PVP-I spray (20 sprays/nostril). Symptom and adverse event questionnaires were completed at baseline, day 3, and day 5. University of Pennsylvania Smell Identification Tests (UPSIT) were completed at baseline and day 30.

RESULTS: Mean cycle threshold (Ct) values increased over time in all groups, indicating declining viral loads, with no statistically significant difference noted in the rate of change between placebo and PVP-I groups. 2.0% PVP-I group showed statistically significant improvement in all symptom categories, however also reported a high rate of nasal burning. Olfaction via UPSIT showed improvement by at least one category in all groups. There were no hospitalizations or mortalities within 30 days of study enrollment.

CONCLUSION: Saline and low concentration PVP-I nasal sprays are well tolerated. Similar reductions in SARS-CoV-2 nasopharyngeal viral load were seen over time in all groups. All treatment groups showed improvement in olfaction over 30 days. These data suggest that dilute versions of PVP-I nasal spray are safe for topical use in the nasal cavity, but that PVP-I does not demonstrate virucidal activity in COVID-19 positive outpatients. This article is protected by copyright. All rights reserved.

PMID:34724213 | DOI:10.1002/lary.29935

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Radiomic analysis to predict local response in locally advanced pancreatic cancer treated with stereotactic body radiation therapy

Radiol Med. 2021 Nov 1. doi: 10.1007/s11547-021-01422-z. Online ahead of print.

ABSTRACT

PURPOSE: Aim of this study is to assess the ability of contrast-enhanced CT image-based radiomic analysis to predict local response (LR) in a retrospective cohort of patients affected by pancreatic cancer and treated with stereotactic body radiation therapy (SBRT). Secondary aim is to evaluate progression free survival (PFS) and overall survival (OS) at long-term follow-up.

METHODS: Contrast-enhanced-CT images of 37 patients who underwent SBRT were analyzed. Two clinical variables (BED, CTV volume), 27 radiomic features were included. LR was used as the outcome variable to build the predictive model. The Kaplan-Meier method was used to evaluate PFS and OS.

RESULTS: Three variables were statistically correlated with the LR in the univariate analysis: Intensity Histogram (StdValue feature), Gray Level Cooccurrence Matrix (GLCM25_Correlation feature) and Neighbor Intensity Difference (NID25_Busyness feature). Multivariate model showed GLCM25_Correlation (P = 0.007) and NID25_Busyness (P = 0.03) as 2 independent predictive variables for LR. The odds ratio values of GLCM25_Correlation and NID25_Busyness were 0.07 (95%CI 0.01-0.49) and 8.10 (95%CI 1.20-54.40), respectively. The area under the curve for the multivariate logistic regressive model was 0.851 (95%CI 0.724-0.978). At a median follow-up of 30 months, median PFS was 7 months (95%CI 6-NA); median OS was 11 months (95%CI 10-22 months).

CONCLUSIONS: This analysis identified a radiomic signature that correlates with LR. To confirm these results, prospective studies could identify patient sub-groups with different rates of radiation dose-response to define a more personalized SBRT approach.

PMID:34724139 | DOI:10.1007/s11547-021-01422-z