Tag: pubmed

J Reconstr Microsurg. 2021 Sep 7. doi: 10.1055/s-0041-1735508. Online ahead of print.

ABSTRACT

INTRODUCTION: In breast surgery, an autologous flap combined with implant may reduce the risk or repair the soft-tissue defects in several cases. Traditionally, the preferred flap is the myocutaneous latissimus dorsi (LD) flap. In the perforator flap era, the evolution of LD flap is the thoracodorsal artery perforator (TDAP) flap. The aim of this study is the comparison between LD flap and TDAP flap with implants in terms of early complications and shoulder function.

METHODS: We performed a retrospective cohort study in accordance with the STROBE guidelines. Between January 1 2015 and January 1 2020, 27 women underwent a unilateral total breast reconstruction with LD or TDAP flap combined with an implant at our institution. 15 women were operated with LD flap and 12 with TDAP flap. The most frequent indications for intervention were results of mastectomy and radiation-induced contracture. We evaluated several data in terms of clinical and demographical characteristics, operative and perioperative factors, and follow-up variables. We assessed shoulder function through the Disability of the Arm, Shoulder and Hand Questionnaire (DASH).

RESULTS: The rate of complications was significantly lower in the TDAP group compared with the LD group (16.7% vs 60.0%, p = 0.047. Table 3). Although the small sample size limited further detailed statistical analyses, we particularly noticed no cases of donor site seroma in the TDAP group, as compared with four in the LD group. Patients in the TDAP group had an ∼11-point lower mean DASH score compared with the LD group (9.8 vs 20.5). This difference was statistically significant (p = 0.049).

CONCLUSIONS: TDAP flap seems to be a reliable technique for soft-tissue coverage in total breast reconstruction with implants. In comparison with the traditional LD flap, it could be a more favorable option in terms of less complications and better quality of life.

PMID:34492716 | DOI:10.1055/s-0041-1735508

Sportverletz Sportschaden. 2021 Sep 7. doi: 10.1055/a-1532-4597. Online ahead of print.

ABSTRACT

BACKGROUND: There is a gap in the literature regarding predictors of rowing performance in young rowers. Therefore, the aim of this study was to investigate associations between parameters of biological maturity, body constitution and physical fitness with rowing performance in young female elite rowers.

METHODS: A total of 26 female rowers aged 13.1 ± 0.5 years (maturity offset: + 2.2 ± 0.5 years from peak height velocity; training volume: 10 hours/week) volunteered to participate in this study. During the performance tests in March 2016/2017, biological maturity (e. g. maturity offset), body constitution (e. g. body height/mass, lean body mass, body fat mass) and physical fitness were assessed. Physical fitness tests included the assessment of muscle strength (1-RM bench pull, leg press, maximal handgrip strength), muscle power (standing long jump test), muscular endurance (trunk muscle endurance test [Bourban test]), dynamic balance (Y-balance test) and change-of-direction speed (multistage shuttle run). Finally, rowing performance was analysed using a 700-m rowing ergometer test. A linear regression analysis was computed for the models (1) biological maturity, (2) biological maturity and body constitution, and (3) biologic maturity, body constitution, and physical fitness.

RESULTS: The statistical analysis showed significant (p≤ 0.01) medium-to-large sized correlations (0.57 ≤r≤ 0.8) between biological maturity, body constitution (e. g. body height/mass, lean body mass) and physical fitness (e. g. 1-RM bench pull, maximal handgrip strength, Bourban test) with rowing performance. Model 3 with the predictors body constitution (i. e. lean mass) and muscular endurance (i. e. Bourban test) showed the largest explained variance for 700-m rowing ergometer performance (R² = 0.94, Akaike information criterion [AIC] = 82.1). Explained variance of model 3 was higher compared with model 1 (R² = 0.6, AIC = 131.5) and model 2 (R² = 0.63, AIC = 111.6).

CONCLUSIONS: As a result of this study, coaches involved in junior rowing should focus on characteristics such as biological maturity, body constitution and physical fitness (muscle strength, muscular endurance) during talent development as these correlated highly with rowing ergometer performance.

PMID:34492718 | DOI:10.1055/a-1532-4597

Am J Perinatol. 2021 Sep 7. doi: 10.1055/s-0041-1735492. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effect of different methods of delivery on the outcome of twin pregnancies.

METHODS: This is a retrospective cohort review of 627 twin pregnancies with delivery from January 2016 to December 2019. According to the clinical guidelines for cesarean section, the cesarean section and vaginal delivery groups were determined. Finally, the baseline information, delivery method, pregnancy outcome, and maternal and infant complications of the two groups were compared.

RESULTS: For different delivery methods, the incidence of preeclampsia was significantly higher in the cesarean section group than in the vaginal delivery group (χ² = 4.405, p < 0.05). There were 23 fetal growth ratios (FGR) in the cesarean section group, which were significantly higher than the vaginal delivery group (χ² = 4.740, p < 0.05). However, the incidence of preterm premature rupture of membranes (PPROM) in the vaginal delivery group was significantly higher than in the cesarean section group (χ² = 5.235, p < 0.05). In addition, the volume of postpartum bleeding in the vaginal delivery group was significantly higher than in the cesarean section group (t = 4.723, p < 0.001). The neonatal weights and 5-minute Apgar scores of the vaginal delivery group were lower than the cesarean section group, and the difference was statistically significant. In the vaginal delivery group, 48 and 26 neonates were transferred to the intensive care and neonatal units, respectively, which were significantly higher than in the cesarean section group (χ² = 5.001, p < 0.05).

CONCLUSION: The major complications of a twin pregnancy are gestational diabetes mellitus and PPROM. Cesarean section can reduce the rate of neonatal asphyxia in twins and improve the pregnancy outcome.

KEY POINTS: · Twin pregnancy. · Delivery methods. · Pregnancy outcomes.

PMID:34492720 | DOI:10.1055/s-0041-1735492

Blood Adv. 2021 Sep 7:bloodadvances.2021004568. doi: 10.1182/bloodadvances.2021004568. Online ahead of print.

ABSTRACT

Patient-reported outcomes (PROs) are relevant and valuable endpoints in the care of patients with myelodysplastic syndromes (MDS). However, a consensus-based selection of PROs for MDS, derived by both patients and hematologists, is lacking. We aimed to develop a core set of PROs for patients with MDS as part of the prospective European LeukemiaNet MDS (EUMDS) Registry. Following international guidelines, candidate PROs were identified from a comprehensive literature search in MDS studies. Overall, 40 PROs were selected and evaluated in a two-round Delphi survey by 40 patients with MDS and 38 hematologists in the first, and 38 and 32 in the second round, respectively. Based on an agreement scale and predefined inclusion criteria, both patients and hematologists selected “general quality of life” as a core PRO. Hematologists also selected “transfusion-dependency burden” and “ability to work/activities of daily living” as core PROs. The second Delphi round increased PRO rating agreements. Statistically significant rating differences between patients and hematologists were observed for 28 PROs (Mann-Whitney U test; p-value <0.05) in the first round and for 19 PROs in the second round, with “disease knowledge” and “confidence in health care services” rated notably higher by patients. The overall mean PRO ratings correlation between the two groups was moderate (Spearman’s rank correlation coefficient=0.5; p-value <0.05). This first consensus on a core set of PROs jointly developed by patients and hematologists forms the basis for patient-centered care in daily practice and clinical research.

PMID:34492684 | DOI:10.1182/bloodadvances.2021004568

Z Geburtshilfe Neonatol. 2021 Sep 7. doi: 10.1055/a-1585-3443. Online ahead of print.

ABSTRACT

INTRODUCTION: The “Delivery Expectancy Questionnaire” by Claas Wijma et al. (W-DEQ_A), which is the most frequently used internationally to determine high levels of fear of childbirth in pregnancy, was not previously available in German. In European countries, Canada, Australia and the United States, fear of childbirth is reported to have a prevalence of 6.3 to 14.8%. Particularly, women with a fear of childbirth have an increased risk for preeclampsia, intrauterine growth retardation, and caesarean sections.

METHODS: An English version of the W-DEQ_A authorized by Claas Wijma was translated and culturally adapted according to the guideline of Ohrbach et al. (INfORM). Content validity was statistically determined by means of the content validity index/average method (S-CVI/Ave).

RESULTS: The translation of all text sections of the W-DEQ_A was subjected to independent appraisal. One introductory question and three items needed to be retranslated. Moreover, three items required rewording to achieve cultural equivalence. The calculated content validity yielded an “excellent” S-CVI/Ave of 0.91.

CONCLUSION: The W-DEQ_A is now available in a German version for the self-assessment of fear of childbirth. It is entitled “Gedanken und Gefühle schwangerer Frauen im Hinblick auf die bevorstehende Geburt”. In the form of a digital health app, the questionnaire could be prescribed and the result directly transferred to the electronic patient record.

PMID:34492707 | DOI:10.1055/a-1585-3443

Ecotoxicol Environ Saf. 2021 Sep 3;225:112725. doi: 10.1016/j.ecoenv.2021.112725. Online ahead of print.

ABSTRACT

Despite the wide application of cobalt nanoparticles (CoNPs), its neurotoxicity and the underlying mechanisms are not fully understood. In this study, CoNPs-induced toxic effect was examined in both C57BL/6J mice and microglial BV2 cells. CoNPs-induced brain weight loss and the reduction of Nissl bodies, assuring neural damage. Moreover, both total unphosphorylated Tau and phosphorylated Tau (pTau; T231 and S262) expressions in the hippocampus and cortex were upregulated, unveiling Tau phosphorylation. Besides, the increase in inflammation-related proteins NLRP3 and IL-1β were found in mice brain. Corroborating that, microglial marker Iba-1 expression was also increased, suggesting microglia-involved inflammation. Among the NADPH oxidase (NOX) family proteins tested, only NOX2 was activated by CoNPs in hippocampus. Therefore, BV2 cells were employed to further investigate the role of NOX2. In BV2 cells, NOX2 expression was upregulated, corresponding to the production of ROS. Moreover, similar induction in Tau phosphorylation and inflammation-related protein expressions were observed in CoNPs-exposed BV2 cells. Treatment of apocynin, a NOX2 inhibitor, reduced ROS generation and reversed Tau phosphorylation and inflammation caused by CoNPs. Thus, CoNPs induced ROS production, Tau phosphorylation and inflammation specially via NOX2 activation.

PMID:34492628 | DOI:10.1016/j.ecoenv.2021.112725

Blood Adv. 2021 Sep 7:bloodadvances.2021004813. doi: 10.1182/bloodadvances.2021004813. Online ahead of print.

ABSTRACT

Post-remission strategies after dasatinib-corticosteroid induction in adults with Ph-positive acute lymphoblastic leukemia (ALL) are not well studied. We evaluated the feasibility and efficacy of dasatinib and dexamethasone induction then protocol-defined post-remission therapies, including hematopoietic cell transplantation (HCT). Adults (N=65) with Ph-positive ALL received dasatinib and dexamethasone induction, methotrexate-based central nervous system (CNS) prophylaxis, reduced-intensity conditioning (RIC) allogeneic HCT, autologous HCT, or chemotherapy alone based on age and donor availability, and dasatinib-based maintenance. Key efficacy endpoints were disease-free survival (DFS) and overall survival (OS). The median age was 60 years (range, 22-87). The complete remission rate was 98.5%. With a median follow up of 59 months, 5-year DFS and OS were 37% (median, 30 months) and 48% (median, 56 months), respectively. For patients receiving RIC allogeneic HCT, autologous HCT, or chemotherapy, 5-year DFSs were 49%, 29%, and 34% and 5-year OSs were 62%, 57%, and 46%, respectively. Complete molecular response rate after CNS prophylaxis was 40%. Relative to the p190 isoform, p210 had shorter DFS (median 10 vs 34 months, P=0.002) and OS (median 16 months vs not reached, P=0.05). Relapse occurred in 25% of allogeneic HCT, 57% of autologous HCT, and 36% of chemotherapy patients. T315I mutation was detected in 6 of 8 marrow relapses. Dasatinib CNS concentrations were low. Dasatinib and dexamethasone followed by RIC allogeneic HCT, autologous HCT, or chemotherapy was feasible and efficacious, especially with RIC allogeneic HCT. Future studies should address the major causes of treatment failure: T315I mutation, the p210 BCR-ABL1 isoform, and CNS relapse.

PMID:34492682 | DOI:10.1182/bloodadvances.2021004813

Leuk Res. 2021 Aug 25;110:106686. doi: 10.1016/j.leukres.2021.106686. Online ahead of print.

ABSTRACT

The mutational status of the variable region of the immunoglobulin heavy chain (IGHV) genes remains the most significant prognostic factor in chronic lymphocytic leukemia (CLL) patients. However, the groups of mutated (M) and unmutated (UM) patients are also heterogeneous, and additional markers are used for a more accurate prognosis. The aim of our work was to determine the prognostic value of the signs of antigen selection determined by BASELINe statistics in M IGHV sequences of CLL patients. Clinical data, IGHV gene configuration, TP53, NOTCH1, SF3B1 mutations were analyzed in 127 CLL patients with M IGHV sequences. The median OS of patients with negative selection in the framework regions (FWRs) of IGHV genes was 120 months compared to 202 month in other CLL patients (P = 0.016). In multivariate Cox regression analysis Binet stage C vs A + B (P < 0.0001), SF3B1 mutations (P < 0.0001), negative selection in the FWRs (HR P = 0.007), and age ≥65 years (P = 0.034) were powerful adverse prognostic factors for OS in CLL patients with M IGHV genes. These preliminary data suggest that the signs of antigen-driven selection may be used as a prognostic factor in CLL patients with M IGHV genes in combination with other markers.

PMID:34492598 | DOI:10.1016/j.leukres.2021.106686

Nutrition. 2021 Jul 30;93:111441. doi: 10.1016/j.nut.2021.111441. Online ahead of print.

ABSTRACT

OBJECTIVES: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic, affecting nearly 180 million people worldwide as of June 22, 2021. Previous studies have examined the association between the mean vitamin D (Vit D) concentration of each country and COVID-19 infection and mortality rate in European countries. The aim of the present study was to critically evaluate the relationship between prevalence of mild and severe Vit D deficiency in each country and COVID-19 infection, recovery, and mortality using updated data and a different methodological approach.

METHODS: Information on Vit D concentration or deficiency for each country was retrieved through a literature search. COVID-19 infections and mortalities per million people and total recoveries, as of June 22, 2021, were obtained. The associations between Vit D deficiency and COVID-19 infection, recovery, and mortality were explored using correlation coefficients and scatterplots.

RESULTS: Non-significant correlations were observed between both number of COVID-19 infections (r = 0.363, P = 0.116) and number of recoveries (r = 0.388, P = 0.091) and the prevalence of mild Vit D deficiency (<50 nmol/L). Similarly, non-significant correlations were observed between both infections (r = 0.215, P = 0.392) and recoveries (r = 0.242, P = 0.332) and the prevalence of severe Vit D deficiency (<30 nmol/L). Significant correlations were found between COVID-19 mortality and prevalence of both mild Vit D deficiency (r = 0.634, P = 0.003) and severe Vit D deficiency (r = 0.538, P = 0.021).

CONCLUSIONS: The prevalence of neither mild nor severe Vit D deficiency was associated with the number of COVID-19 infections in European countries. Thus, it is an important parameter to consider when implementing preventive measures to face COVID-19.

PMID:34492624 | DOI:10.1016/j.nut.2021.111441

Eat Behav. 2021 Jul 24;43:101542. doi: 10.1016/j.eatbeh.2021.101542. Online ahead of print.

ABSTRACT

The utility of traditional eating disorder measures in the assessment of muscularity-oriented disordered eating has been questioned. To address this limitation, the Muscularity-Oriented Eating Test (MOET) was recently developed and validated in a sample of U.S. college men. We aimed to develop a multicultural Spanish-language version of the MOET for use in Latin American samples and validate its use in a sample of Argentinian college men. Combined translation procedures were used to develop a version suitable for different Spanish-speaking populations. A total of 235 students (M_age = 23.47, SD = 5.61) participated in this study by completing a survey including the MOET. A sub-sample (n = 121) completed the MOET again after 1 week. A confirmatory factor analysis of a re-specified model of the original single-factor MOET, allowing for residual correlation between items associated to dietary rules (items 4-12), resulted in an adequate fit (χ²/df = 2.10, CFI = 0.94, TLI = 0.93, RMSEA 0.05 [90% CI = 0.04, 0.06] SRMR = 0.08). Further, the multicultural Spanish-language version of the MOET yielded evidence of internal consistency (omega = 0.83, 95% CI [0.79, 0.88], Cronbach’s α = 0.83), a 1-week Intraclass Correlation Coefficient was considered for test-retest reliability (ICC = 0.82), item analysis, convergent validity with measures of eating disorder psychopathology, body dissatisfaction and weight-related behaviors, as well as for divergent validity with an unrelated construct. The availability of a multicultural Spanish-language version of the MOET may have utility in both clinical and research efforts related to muscularity-oriented disordered eating among Latino men.

PMID:34492593 | DOI:10.1016/j.eatbeh.2021.101542