Tag: pubmed

Eur J Obstet Gynecol Reprod Biol. 2021 Feb 19;260:42-47. doi: 10.1016/j.ejogrb.2021.02.017. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare efficacy of myoinositol as an adjuvant to dietary modification for treatment of gestational diabetes mellitus in Asian Indian women compared to controls.

STUDY DESIGN: Setting: This pilot randomized open label trial was conducted in a single antenatal clinic in India.

SUBJECTS: One hundred women with singleton pregnancy and gestational diabetes diagnosed between 14-28 weeks’ gestation were included. Overt diabetes, twin pregnancy, pre-existing renal disease, heart disease and other chronic medical disorders were exclusions.

INTERVENTION: Participants were randomized in two groups (1:1 ratio) by opaque envelope method. Individualized nutrition counseling with dietary modification and routine antenatal care was provided to all. Fifty women received myoinositol 1000 mg twice daily; 50 controls did not receive myoinositol. Fasting and postprandial glucose levels were assessed after two weeks. Women not achieving glycemic targets (fasting glucose <95 and postprandial glucose <120 mg/dL) were given pharmacologic therapy. Contributory factors in women requiring additional pharmacologic therapy, maternal and fetal outcomes were noted.

STATISTICAL ANALYSIS: Between group comparisons reported relative risk and mean difference. To assess predictive factors for need for pharmacologic therapy, univariate and multivariable logistic regression analysis were used.

RESULTS: Baseline characteristics were comparable in both groups. Except one woman in the myoinositol group, all women provided glycaemia data throughout their pregnancy. Glycemic control was achieved in 44/ 49 (89.8 %) women in myoinositol group which was significantly higher than 34/50 (68 %) in the controls ((relative risk 0.31, 95 % confidence interval 0.13 to 0.80, p = 0.008). Mean duration of myoinositol treatment was 17.6 weeks (standard deviation 5.3). Additional treatment with metformin/insulin was needed in all women failing to achieve glycaemic control. The mean (range) dose of insulin was 25.3 units in myoinositol group compared to 14.27 units in controls (p = 0.058). Secondary outcomes were similar in two groups except baby weight which was higher in controls (p = 0.018).

CONCLUSIONS: Oral supplementation with myoinositol in dose of 1 gm twice-daily, when started soon after the diagnosis of GDM, is effective in achieving glycemic control and decreasing the need for additional pharmacological therapy in Asian Indian women.

PMID:33721623 | DOI:10.1016/j.ejogrb.2021.02.017

Prev Vet Med. 2021 Feb 22;189:105306. doi: 10.1016/j.prevetmed.2021.105306. Online ahead of print.

ABSTRACT

Inadequate transfer of passive immunity (TPI) is associated with increased risk for calfhood disease and increased risk of mortality and morbidity. Accurately diagnosing calves and herds with inadequate TPI is of primary importance and brix (BRIX) or classical refractometer (REF) devices are more practical for this purpose than measuring the serum immunoglobulin G concentration in neonatal calves. We previously reported a systematic review and meta-analysis for quantifying the pooled accuracy of BRIX and REF for detecting calves with serum IgG < 10 g/L noting that sparse data were available especially because studies did not report the same thresholds. We updated the previous systematic review using different methods that accounted for the test results distribution in calves with or without inadequate TPI. With this approach, all reported cut-offs for a specific study are used in that Bayesian approach that quantifies how accuracy varied among all reported thresholds. Five new manuscripts were included, which represented 4 new studies since the initial study was performed. A total of 11 REF and 9 BRIX studies were available. The meta-analytic methods allowed reporting variation of the true and false positive rate across and among all reported cut-offs. Pooled points estimates (95 % Bayesian credible intervals) for sensitivity (Se) and specificity (Sp) of REF < 5.5 g/L were 86.1 % (68.5-97.9%) and 76.2 % (65.9-88.4%) whereas BRIX < 8.4 % was associated with Se of 91.6 % (77.2-99.5%) and Sp of 88.2 % (65.4-99.8%). Interestingly, the accuracy (Se + Sp-1) was generally higher for BRIX than for REF at the reported cut-offs. Besides the benefit of providing pooled estimates for all reported and unreported BRIX and REF thresholds, the general framework used in this study could potentially be used in many veterinary diagnostic tests studies that reported multiple thresholds accounting for potentially different tests distributions in population with and without the target condition.

PMID:33721672 | DOI:10.1016/j.prevetmed.2021.105306

Leuk Lymphoma. 2021 Mar 10:1-9. doi: 10.1080/10428194.2021.1889539. Online ahead of print.

ABSTRACT

The Swedish national guidelines for treatment of acute myeloid leukemia (AML) recommend analysis of measurable residual disease (MRD) by multiparameter flow cytometry (MFC) in bone marrow in the routine clinical setting. The Swedish AML registry contains such MRD data in AML patients diagnosed 2011-2019. Of 327 patients with AML (non-APL) with MRD-results reported in complete remission after two courses of intensive chemotherapy 229 were MRD-negative (70%), as defined by <0.1% cells with leukemia-associated immunophenotype in the bone marrow. MRD-results were reported to clinicians in real time. Multivariate statistical analysis adjusted for known established risk factors did not indicate an association between MFC-MRD and overall survival (HR: 1.00 [95% CI 0.61, 1.63]) with a median follow-up of 2.7 years. Knowledge of the importance of MRD status by clinicians and individualized decisions could have ameliorated the effects of MRD as an independent prognostic factor of overall survival.

PMID:33719843 | DOI:10.1080/10428194.2021.1889539

Clin Exp Optom. 2021 Mar 15:1-4. doi: 10.1080/08164622.2021.1896335. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: The relationship between the cornea and systemic autoimmune diseases has been demonstrated in prior studies. Corneal Visualisation Scheimpflug Technology (Corvis ST) provides a specific and detailed assessment of corneal biomechanical features, such as stiffness and elasticity.

BACKGROUND: This study aims to evaluate corneal biomechanical changes in patients with systemic autoimmune diseases using Corvis ST.

METHODS: This prospective study included 36 patients with ankylosing spondylitis (AS), 38 patients with rheumatoid arthritis (RA), and 36 age- and sex-matched healthy subjects. After ophthalmologic examinations Pentacam HR and Corvis ST was performed on all eyes. The mean keratometric and pachymetric data, corneal biomechanical parameters, biomechanical intraocular pressure (bIOP) were analysed.

RESULTS: There was no statistically significant differences among the groups regarding age, gender, refraction, visual acuity, IOP, pachymetry and keratometry. Compared to healthy controls, the mean velocity values of applanation 1 (A1V) and 2 (A2V), deformation amplitude (DA), and corvis biomechanical index (CBI) were statistically significantly higher and stiffness parameter at first applanation (SPA1) was statistically significantly lower in AS and RA patients (all p < 0.05). In both AS and RA groups, disease duration was found to be negatively correlated with SPA1 (p = 0.043, 0.027, respectively) and positively correlated with CBI (p = 0.022, 0.020, respectively).

CONCLUSION: AS and RA patients have a decreased corneal stiffness compared to healthy subjects. Disease duration seems to be correlated with these changes.

PMID:33719873 | DOI:10.1080/08164622.2021.1896335

Leuk Lymphoma. 2021 Mar 10:1-6. doi: 10.1080/10428194.2021.1885663. Online ahead of print.

ABSTRACT

Among acute myeloid leukemia (AML) patients treated with 7 + 3 induction, we evaluate the association between complete morphologic remission (CR) and long-term overall survival (OS) over four decades. We analyzed 1247 patients age ≤65 randomized to 7 + 3 arms from five SWOG studies. OS has improved over the four decades. Hazards for death in the two most recent studies fell after year 2. In multivariable models, decade of therapy was the most important variable with respect to long-term survival and CR by day 100 the second most important variable. Protocol/decade, which captures many factors not included in our multivariable model, was the most important predictor of being alive at year 2 or 3. The next most important factor was achievement of first CR by day 100.

PMID:33719833 | DOI:10.1080/10428194.2021.1885663

Hum Fertil (Camb). 2021 Mar 15:1-10. doi: 10.1080/14647273.2021.1900608. Online ahead of print.

ABSTRACT

There is increasing data that IVS8-5T variand and TG repeats could lead to impaired spermatogenesis. To investigate this we performed Sanger sequencing on 50 Bulgarian men with a sperm count below 5 × 10⁶/mL and 20 normal fertile men. Frequencies of the results were compared among the two groups. A meta-analysis was perfomed by using the data for 6,423 patients and 5,834 control subjects, tested for the IVS8-5T polymorphism. One case subject (2.0%) was homozygote for the 5 T/5T variant whereas two (4.0%) were heterozygotes for the 5 T/7T variant. No 5 T alleles were found in the control group. The genotypes of the two groups showed a statistically significant difference (p = 0.04, α < 0.05). Also, the odds ratio was 3.73, but this was unsignificant (p = 0.38). All control subjects had 11 TG repeats and for the test group: 47 (94.0%) men with 11 TG repeats and three (6.00%) with 10 TG repeats. Fisher’s test showed no significant difference (p = 0.55). The meta-analysis showed that IVS8-5T variant was a risk factor for impaired spermatogenesis (OR = 2.84, p < 0.05) and this was more prominent for non-European (OR = 4.50, p < 0.05) compared to European (OR = 1.28, p < 0.05) men. The IVS8 – 5 T variant could be associated with disorders of sperm production.

PMID:33719834 | DOI:10.1080/14647273.2021.1900608

Somatosens Mot Res. 2021 Mar 9:1-6. doi: 10.1080/08990220.2021.1879777. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to examine time perception impairment in multiple sclerosis (MS) patients.

METHOD: The study was performed with 60 MS patients and 60 age-matched healthy people. Estimation and Production Tests were carried out with a standard personal laptop computer and participants were aware to count the seconds by the ‘start’ command and to stop by the ‘stop’ command. The outcome measure was the ratio between the estimated duration and the target (7 s, 32 s, or 58 s) one for the Estimation Test and the Produced duration and the target (7 s, 32 s, or 58 s) one for the Production Test; and each time duration was repeated three times both for Production and Estimation Tests.

RESULTS: We found a significant difference in the Estimation Test (7 s, 32 s, 58 s), and the Production Test (7 s, 32 s, 58 s) between the MS group and healthy control group (p < .05). It was observed that patients with MS had a higher deviation from the target time compared to the control group. It was found that this difference was statistically significant (p < .05). There was a high and negative correlation between the Estimation and Production Tests in MS patients.

CONCLUSION: In conclusion, our data suggests that time estimation and production are disturbed in MS patients, and cognitive rehabilitation is required for most of them.

PMID:33719839 | DOI:10.1080/08990220.2021.1879777

Eur J Contracept Reprod Health Care. 2021 Mar 15:1-7. doi: 10.1080/13625187.2021.1891409. Online ahead of print.

ABSTRACT

INTRODUCTION: Contraceptive counselling is essential in women with chronic disease, though it is frequently overlooked. We aimed to assess practices and awareness in contraceptive counselling in hospital physicians caring for reproductive age women with chronic disease.

METHODS: A questionnaire was distributed in April 2017 to physicians from 16 medical specialties in a tertiary care hospital in Portugal. Statistical analysis performed using Microsoft Office Excel^® and IBM SPSS-Statistics^®.

RESULTS: Two-hundred physicians participated in the survey: 59.5% were female, 55% under 35 years-old and 48.5% were residents. Only 26.5% practiced in surgical specialties. Two-thirds consistently inquired about the use of contraception. Most referred patients to Family Planning services or performed contraceptive counselling when pregnancy posed significant health risks (89.0%), when prescribing teratogenic medication (79.5%) or drugs with potential interaction with contraceptives (75.0%). Lack of training in contraception was the main reason for not referring patients to Family Planning services. While 83% considered counselling very important, only 5% had recently undergone training and 12.5% felt knowledgeable enough to perform it. Only 12.5% were aware of the institution’s Family Planning resources. Female gender, non-surgical specialty, age over 35 years-old and over 10 years since specialisation were positively associated with awareness.

CONCLUSION: Most physicians addressed contraceptive management in women with comorbidities, but adequate training is lacking. Our results highlight the importance of communication between health care providers to achieve an adequate and multidisciplinary approach to reproductive and general health goals.

PMID:33719811 | DOI:10.1080/13625187.2021.1891409

Cutan Ocul Toxicol. 2021 Mar 15:1-27. doi: 10.1080/15569527.2021.1902341. Online ahead of print.

ABSTRACT

AIM: To investigate the corneal epithelial and limbal epithelial alterations in patients under topical glaucoma treatment using anterior segment-OCT (AS-OCT) and to determine the changes of the limbal region due to the preservatives and glaucoma drugs, that can progress to limbal stem cell deficiency (LSCD). Limbal thickness was measured by AS-OCT to evaluate limbal cell deficiency.

METHODS: Forty-seven patients using topical medication for glaucoma, and 48 control subjects were enrolled in this matched case-control study. The patients were divided into four groups according to the treatment regimens. Group 1: One-drug regimen, Group 2: Two-drug regimen, Group 3: Three-drug regimen, Group 4: Four-drug regimen For the ocular surface evaluation; tear break-up time with standard fluorescein sodium sterile strip application, Schirmer test-I, Ocular Surface Disease Index Questionnaire, and AS-OCT were performed.

RESULTS: A total of 95 subjects were included: 47 eyes of 47 patients with glaucoma medication and 48 eyes of 48 healthy subjects. There was a statistically significant difference between patients and controls according to BUT, SCH, and OSDI (P < 0.001). The mean central corneal epithelium thickness was 48.5 ± 5.3 in patients and 54.5 ± 5.9 in controls (P < 0.001). The mean central total corneal thickness was 529.2 ± 41.2 in patients and 536 ± 35.3 in controls (P = 0.335). The mean limbal epithelium thickness was 64.1 ± 9.1 in patients and 76 ± 11.5 in controls (p < 0.001).

CONCLUSION: Using at least one glaucoma drug caused limbal area injury, changed ocular surface measurements, and significantly reduced the limbal epithelial thickness where the stem cells reside. The limbal epithelial thickness measurement by AS-OCT seems to be an innovative, non-invasive, and promising technique for detecting and staging corneal damage in topical glaucoma therapy.

PMID:33719786 | DOI:10.1080/15569527.2021.1902341

Int J Audiol. 2021 Mar 15:1-5. doi: 10.1080/14992027.2021.1894492. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate whether hearing difficulties exacerbate the damaging effects of enforced social distancing due to the COVID-19 pandemic on isolation and loneliness, and lead to accelerated mental health issues and cognitive dysfunction.

DESIGN: Rapid online survey. Participants completed a series of online questionnaires regarding hearing ability, socialisation (pre- and during-pandemic), loneliness, anxiety, depression and cognitive function.

STUDY SAMPLE: A total of 80 participants over the age of 70 with access to the internet.

RESULTS: There was a significant reduction in socialisation levels from pre-pandemic in this population. Hearing difficulties were significantly associated with greater levels of loneliness, depression and self-perceived cognitive dysfunction after controlling for age, gender, and level of education. Additionally, compared to pre-pandemic, people with hearing difficulties had increased odds of reporting worsened anxiety, depression, and memory during the COVID-19 pandemic, although only the effect of hearing difficulties on the change in memory reached statistical significance after controlling for age, gender, and level of education.

CONCLUSIONS: The worse the self-reported hearing abilities are, the greater the negative impact of enforced social distancing on depression, loneliness and cognitive function.

PMID:33719793 | DOI:10.1080/14992027.2021.1894492