Tag: pubmed

Neurosurg Focus. 2021 Sep;51(3):E9. doi: 10.3171/2021.6.FOCUS21112.

ABSTRACT

OBJECTIVE: This prospective study was designed to confirm the role of atorvastatin in collateral circulation formation induced by encephaloduroarteriosynangiosis (EDAS) in patients with moyamoya disease (MMD).

METHODS: Patients who were diagnosed with MMD at the Department of Neurosurgery in the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China, between June 2017 and May 2018 were included. Blood samples were obtained from an antecubital vein and were analyzed using flow cytometry. Endothelial progenitor cells (EPCs) were defined as CD34brCD133+CD45dimKDR+. All patients included in the study underwent EDAS. Patients voluntarily chose whether to undergo atorvastatin treatment after EDAS. The correlation between atorvastatin and good postoperative collateral circulation was evaluated.

RESULTS: A total of 106 patients with MMD were included in this study. Fifty-three patients (50%) received atorvastatin treatment. The baseline characteristics did not display statistically significant differences between the atorvastatin-treated and non-atorvastatin groups. Seventy-eight (42.9%) of the 182 hemispheres investigated postoperatively were classified as grade A collateral circulation, 47 (25.8%) as grade B, and 57 (31.3%) as grade C. Multivariate analysis revealed that only atorvastatin was significantly correlated with good collateral circulation after EDAS (p = 0.041).

CONCLUSIONS: The results of this prospective clinical trial have indicated that atorvastatin administered at 20 mg daily is safe and effective for the formation of postoperative collateral induced by EDAS.

PMID:34469867 | DOI:10.3171/2021.6.FOCUS21112

Neuroimage. 2021 Aug 29;243:118518. doi: 10.1016/j.neuroimage.2021.118518. Online ahead of print.

ABSTRACT

Null models are useful for assessing whether a dataset exhibits a non-trivial property of interest. These models have recently gained interest in the neuroimaging community as means to explore dynamic properties of functional Magnetic Resonance Imaging (fMRI) time series. Interpretation of null-model testing in this context may not be straightforward because (i) null hypotheses associated to different null models are sometimes unclear and (ii) fMRI metrics might be ‘trivial’, i.e. preserved under the null hypothesis, and still be useful in neuroimaging applications. In this commentary, we review several commonly used null models of fMRI time series and discuss the interpretation of the corresponding tests. We argue that, while null-model testing allows for a better characterization of the statistical properties of fMRI time series and associated metrics, it should not be considered as a mandatory validation step to assess their relevance in representing brain functional dynamics.

PMID:34469853 | DOI:10.1016/j.neuroimage.2021.118518

Psychiatry Res. 2021 Aug 21;305:114173. doi: 10.1016/j.psychres.2021.114173. Online ahead of print.

ABSTRACT

Using daily vital statistics data from the Japanese Ministry of Health, Labour and Welfare, we provide the first weekly and age-group-specific estimates of the additional suicide burden during the COVID-19 pandemic in Japan by gender, from January through November 2020. Our results indicate that compared with the previous five years, suicide cases in 2020 in Japan have increased from late July to November for women in all age groups and for men in the 20-29 and 80+ years age group. Targeted interventions based on age and gender might be more effective in reducing suicide during the COVID-19 pandemic in Japan.

PMID:34469804 | DOI:10.1016/j.psychres.2021.114173

J Minim Invasive Gynecol. 2021 Aug 29:S1553-4650(21)00404-0. doi: 10.1016/j.jmig.2021.08.018. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE: To investigate the therapeutic efficacy of catheter-directed ethanol sclerotherapy (CDS) and its effect on ovarian reserve in patients with endometrioma at risk of decreased ovarian reserve.

DESIGN: A retrospective study.

SETTING: A teaching hospital.

PATIENTS: We evaluated 18 patients with ovarian endometrioma measuring ≥3 cm and pre-procedural serum anti-Müllerian hormone (AMH) levels of <2 ng/mL.

INTERVENTIONS: An 8.5-F catheter was inserted either transabdominally or transvaginally into the endometrioma. Following aspiration, sclerotherapy with 99% ethanol was performed, with subsequent 20-minute ethanol retention.

MEASUREMENTS AND MAIN RESULTS: Ultrasonography (US) was performed pre-procedurally and 6 months following CDS to evaluate any recurrence or changes in cyst size. Further, serum AMH levels, CA-125 levels, and the visual analog scale (VAS) scores for dysmenorrhea were obtained to analyze the ovarian reserve and treatment efficacy, pre-procedurally and at 6 months after CDS. The mean cyst size on US and serum CA-125 levels decreased 6 months after CDS (p < .001, and p = .001, respectively). All patients reported a decreased VAS score for dysmenorrhea (p < .001). However, the difference in serum AMH levels before and after CDS was statistically insignificant (p = .875).

CONCLUSION: CDS was efficacious in reducing pain and serum CA-125 levels in patients with low AMH levels without adversely affecting their ovarian reserve.

PMID:34469826 | DOI:10.1016/j.jmig.2021.08.018

Int J Drug Policy. 2021 Aug 29;98:103400. doi: 10.1016/j.drugpo.2021.103400. Online ahead of print.

ABSTRACT

BACKGROUND: The Ottawa Inner City Health’s Managed Opioid Program is the first, to our knowledge, to pair injectable opioid agonist hydromorphone treatment with assisted housing for people experiencing homelessness with severe opioid use disorder (OUD) and injection drug use. We aimed to describe this program and evaluate retention, health, and social wellbeing outcomes.

METHODS: We retrospectively assessed the first cohort of clients enrolled in the Managed Opioid Program between August 2017-2018. The primary outcome was retention at 12 months. Secondary outcomes included injectable and oral opioid dose titration, non-prescribed opioid use, overdoses, connection with behavioural health services, and social well-being. Descriptive statistics were used to summarize baseline demographics and secondary outcomes. Actuarial survival analysis was used to assess retention among participants.

RESULTS: The study sample included 26 participants: median age was 36 years, 14 were female, 22 were White, eight had alcohol use disorders, 25 had stimulant use disorders, and all had a history of concurrent psychiatric illness. Retention at 12 months was 77% (95% CI 62-95). Throughout the first-year participants’ opioid treatment doses increased. The median daily dose of injectable hydromorphone was 36 mg [17-54 mg] and 156 mg [108-188 mg] at enrollment and one year respectively. The median daily dose of oral opioid treatment was 120-milligram morphine equivalents [83-180 mg morphine equivalents] and 330-milligram morphine equivalents [285-428 mg morphine equivalents] at enrollment and one year respectively. Over half had no overdoses and there were no deaths among participants who remained enrolled. At one year, 45% stopped non-prescribed opioid use, 96% connected to behavioral health services, 73% reconnected with estranged families, and 31% started work or vocational programs.

CONCLUSION: Individuals with severe OUD engaged in injectable hydromorphone treatment and housing showed high retention in care and substantive improvements in patient-centered health and social well-being outcomes.

PMID:34469781 | DOI:10.1016/j.drugpo.2021.103400

J Neurophysiol. 2021 Sep 1. doi: 10.1152/jn.00181.2021. Online ahead of print.

ABSTRACT

Huntington’s disease (HD) is a fatal, hereditary neurodegenerative disorder that predominantly affects striatal medium-sized spiny neurons and cortical pyramidal neurons (CPNs). It has been proposed that perturbations in Ca²⁺ homeostasis could play a role in CPN alterations. To test this hypothesis, we used the R6/2 mouse model of juvenile HD at different stages of disease progression; presymptomatic, early symptomatic, and late symptomatic. We combined whole-cell patch clamp recordings of layer 2/3 CPNs with two-photon laser scanning microscopy to image somatic and dendritic Ca²⁺ transients associated with evoked action potentials (APs). We found that the amplitude of AP-induced Ca²⁺ transients recorded at the somata of CPNs was significantly reduced in presymptomatic and late symptomatic R6/2 mice compared to wildtype (WT) littermates. However, reduced amplitudes were compensated by increases in decay times, so that Ca²⁺ transient areas were similar between genotypes. AP-induced Ca²⁺ transients in CPN proximal dendrites were variable and differences did not reach statistical significance, except for reduced areas in the late symptomatic group. In late symptomatic mice, a specific store-operated Ca²⁺ channel antagonist, EVP4593, reduced somatic Ca²⁺ transient amplitude similarly in WT and R6/2 CPNs. In contrast, dantrolene, a ryanodine receptor (RyR) antagonist, and nifedipine, an L-type Ca²⁺ channel blocker, significantly reduced both somatic Ca²⁺ transient amplitude and area in R6/2 but not WT CPNs. These findings demonstrate that perturbations of Ca²⁺ homeostasis and compensation occur in CPNs before and after the onset of overt symptoms, and suggest RyRs and L-type Ca²⁺ channels as potential targets for therapeutic intervention.

PMID:34469694 | DOI:10.1152/jn.00181.2021

Environ Res. 2021 Aug 29:111977. doi: 10.1016/j.envres.2021.111977. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: The neurobiological processes involved in establishing sleep regulation are vulnerable to environmental exposures as early as seven weeks of gestation. Studies have linked. in utero pesticide exposure to childhood sleep-disordered breathing. However, the impact of in utero pesticide exposure on the sleep health of adolescents remains unexplored.

MATERIALS AND METHODS: Data from 137 mother-adolescent pairs from a Mexico City cohort were analyzed. We used maternal urinary 3-phenoxybenzoic acid (3-PBA, pyrethroid metabolite) and 3, 5, 6-trichloro-2-pyridinol (TCPy, chlorpyrifos metabolite) from trimester three to estimate in utero pesticide exposure. Among adolescents, we obtained repeated measures of objectively assessed sleep duration, midpoint, and fragmentation using wrist-actigraphy devices for 7 consecutive days in 2015 and 2017. Unstratified and sex-stratified associations between maternal urinary 3-PBA and TCPy and adolescent sleep measures were examined using linear mixed models. We also examined the interactive effects of maternal pesticide exposure and offspring sex on sleep outcomes.

RESULTS: 3-PBA and TCPy were detected in 44.4% and 93% of urine samples, respectively. In adjusted models, we observed monotonic associations between TCPy with longer sleep duration and later sleep midpoint. Adjusted findings demonstrated that higher exposure to maternal TCPy was associated with longer sleep duration (p, trend = 0.01), and later sleep timing (p = 0.07). Findings from interaction tests between exposure and offspring sex were not statistically significant. Adjusted sex-stratified findings showed that the association between TCPy with duration and midpoint was evident only among female offspring; those in the highest tertile of exposure had a 59 min (95% CI: 12.2, 104.8) (p, trend = 0.004) longer sleep duration and a 0.6 h (95% CI: 0.01, 1.3) (p, trend = 0.01) later sleep midpoint. We found no significant associations between 3-PBA and sleep outcomes.

CONCLUSION: Although findings from interaction tests were not statistically significant, effect estimates demonstrated that associations between maternal pesticide exposure and longer sleep duration and later sleep timing were stronger in female offspring.

PMID:34469742 | DOI:10.1016/j.envres.2021.111977

Rural Remote Health. 2021 Sep;21(3):5865. doi: 10.22605/RRH5865. Epub 2021 Sep 1.

ABSTRACT

INTRODUCTION: In various countries, a shortage of general practitioners (GPs) and worrying health statistics on risk factors, morbidity and mortality have been observed in rural areas. However, few comparative data are available on GP activities according to their location. The aim of this study was to analyse French GP activities according to their rural or urban practice location.

METHODS: This study was ancillary to the El&eacute;ments de la COnsultation en m&eacute;decine GEN&eacute;rale (ECOGEN) study, which was a cross-sectional, multicentre, national study conducted in 128 French general practices in 2012. Data were collected by 54 interns in training during a period of 20 working days from December 2011 to April 2012. GP practice location was classified as rural area, urban cluster or urban area. The International Classification of Primary Care (ICPC-2) was used to classify reasons for encounter, health problem assessments, and processes of care. Univariate analyses were performed for all dependent variables, then multivariable analyses for key variables, using hierarchical mixed-effect models.

RESULTS: The database included 20 613 consultations. The mean yearly number of consultations per GP was higher in rural areas (p<0.0001), with a shorter consultation length (p<0.0001). No difference was found for GP sex (p=0.41), age (p=0.87), type of fees agreement (p=0.43), and type of practice (p=0.19) according to their practice location. Urban patients were younger, and there was a lower percentage of patients over 75 years (p<0.001). GPs more frequently consulted at patients’ homes in rural areas (p<0.0001). The mean number of chronic conditions managed was higher in rural areas and urban clusters than in urban areas (p<0001). Hypertension (p<0.0001), type 2 diabetes (p=0.003), and acute bronchitis/bronchiolitis (p=0.01) were more frequently managed in rural areas than in urban clusters and areas. Health maintenance/prevention (p<0.0001) and no disease situations (p<0.0001) were less frequent in rural areas. Drug prescription was more frequent in rural areas than in urban clusters and areas (p<0.0001). Multivariable analysis confirmed the influence of a GP’s rural practice location on the consultation length (p<0.0001), the number of chronic conditions per consultation (p<0.0001) and the number of health maintenance/prevention situations (p<0.0001), and a trend towards a higher yearly number of consultations per GP (p=0.09).

CONCLUSION: French rural GPs tend to have a higher workload than urban GPs. Rural patients have more chronic conditions to be managed but are offered fewer preventive services during consultations. It is necessary to increase the GP workforce and develop cooperation with allied health professionals in rural areas.

PMID:34469693 | DOI:10.22605/RRH5865

Int Braz J Urol. 2021 Nov-Dec;47(6):1150-1159. doi: 10.1590/S1677-5538.IBJU.2021.0161.

ABSTRACT

PURPOSE: To evaluate the efficacy of intravaginal electrical stimulation (IVES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB).

MATERIALS AND METHODS: Sixty-two women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n:31), and Group 2 received BT+IVES (n:31). IVES was performed for twenty minutes three days a week over a course of eight weeks for a total of 24 sessions. Patients were evaluated in terms of incontinence severity (24-hour pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes and number of pads), symptom severity (OAB-V8), incontinence-related QoL (IIQ-7), treatment success (positive response rate), cure/improvement rate and treatment satisfaction (Likert scale).

RESULTS: A statistically significant improvement was found in all parameters for all groups at the end of the treatment compared to the baseline values except pelvic floor muscles strength in Group 1 (p < 0.05). At the end of treatment, incontinence severity, frequency of voiding, nocturia, incontinence episodes, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p < 0.05). Treatment satisfaction, cure/improvement, and positive response rates were significantly higher in group 2 compared to Group 1 (p < 0.05).

CONCLUSION: We conclude that BT+IVES were more effective than BT alone on both incontinence-related QoL and clinical parameters in women with idiopathic OAB.

PMID:34469668 | DOI:10.1590/S1677-5538.IBJU.2021.0161

Dermatol Ther. 2021 Sep 1:e15119. doi: 10.1111/dth.15119. Online ahead of print.

ABSTRACT

Chronic urticaria is in some cases very difficult to treat, we aimed to evaluate the effect of colchicine on chronic urticaria management. Fifty-five euthyroid patients with chronic urticaria were examined based on UQL and UAS7 questionnaires. The overall UQL-Q score after three months has not any statistical difference between groups. The overall UQL-Q score changes between groups was not statistically different. However, the UQL-Q score significantly reduces during study period in each group. In conclusion, colchicine can manage the sign and symptoms of chronic urticaria which improve the patients’ quality of life. This article is protected by copyright. All rights reserved.

PMID:34469631 | DOI:10.1111/dth.15119