Tag: pubmed

Nutrition. 2021 May 26;91-92:111354. doi: 10.1016/j.nut.2021.111354. Online ahead of print.

ABSTRACT

OBJECTIVES: We sought to compare complications associated with tunneled peripherally inserted central catheters (tPICCs) and tunneled-cuffed centrally inserted central catheters (tCICCs) in adult home parenteral nutrition (HPN).

METHODS: The study (2017-2019) identified 257 people with type III chronic intestinal failure requiring HPN. The data were analyzed for tPICC- and tCICC-related complications. The rate of catheter-related complications was recorded as the number of complications analyzed per 1000 d of catheter use, and rates were compared using the Mann-Whitney Wilcoxon test.

RESULTS: A total of 273 venous access devices were included to the analyses: 150 (55%) non-cuffed tPICCs and 123 (45%) tCICCs. In-dwelling time for tPICCs and tCICCs were 23 045 and 43 789 catheter d, respectively. Median (interquartile range) catheter days and duration of HPN, for tPICCs and tCICCs, were respectively 119 (166) and 324 (314) d and 108 (159) and 324 (322) d. The overall complication rates per 1000 catheter d for tPICCs and tCICCs were 1.52 and 0.8, respectively (P = 0.565). On analysis, there was no statistical difference between complication rates per 1000 catheter d. The removal rate and conversion ratio due to complications were similar for tPICCs and tCICCs.

CONCLUSIONS: Both tPICCs and tCICCs have similar complication rates per 1000 d. This study highlights that tCICCs, the preferred and currently used venous access devices in HPN, can be effectively and safely replaced by tPICCs, depending on the indications.

PMID:34246088 | DOI:10.1016/j.nut.2021.111354

J Environ Manage. 2021 Jul 7;296:113219. doi: 10.1016/j.jenvman.2021.113219. Online ahead of print.

ABSTRACT

Little is known about the relationship between traffic congestion and antimony (Sb) distribution in street dust, which is essential for Sb control and emission reduction in urban areas. Sb concentrations and mass load of the street dust collected in 19 cities of China were determined before investigating the mechanism of traffic influence on Sb distribution through diverse statistical means. The results showed that the Sb concentrations in each city were 1.10-4.76 times higher than the local background values. Sb concentrations in transportation areas were significantly higher than those in residential and industrial areas, and were significantly affected by road network density. The effect of congestion on Sb load of street dust was influenced by vehicle flowrate. Only when the vehicle flowrate was high, the traffic congestion would promote the increase of Sb load obviously. The improved accounting method showed that the Sb dissipation from brake wear in major Chinese cities were higher than that in Stockholm, Sweden, in 2005. The latent path analysis illustrated that a 1% increase in congestion index was correlated with a 0.886% increase in the Sb load. Compared with Switzerland, which has a typical industrialized Sb consumption pattern, China needs to recycle brake pads in addition to taking various measures to alleviate traffic congestion and reduce brake pad wear, despite the fact that the maximum health risk of Sb was far below the safety threshold. This study will provide valuable insights for urban traffic management and brake pad recycling.

PMID:34246026 | DOI:10.1016/j.jenvman.2021.113219

Am J Otolaryngol. 2021 Jun 29;42(5):103157. doi: 10.1016/j.amjoto.2021.103157. Online ahead of print.

ABSTRACT

BACKGROUND: Dysphonia is a feature of the COVID-19 disease with different prevalence rates of occurrence among various nations.

OBJECTIVES: To determine the prevalence of dysphonia in hospitalized patients with COVID-19 disease.

MATERIALS AND METHODS: The study was conducted at Salahaddin General Hospital during the period from January to March 2021. Hospitalized COVID-19 patients with or without dysphonia were enrolled in the study. Demographic and clinical data were recorded. The severity, duration, laryngoscopic finding, and fate of the dysphonia were registered too.

RESULTS: Out of 94 subjects, there were 21 (22.3%) with dysphonia. The age was ranged from 23 to 101 years, with nearly equal gender distribution. Non-smokers were found in 52.1% of the cases. Dyspnea (100%), fever (100%), and cough (98.9%) were the most common presenting symptoms. There was a statistically significant difference between the dysphonic and non-dysphonic groups regarding fatigue, nasal obstruction, and diarrhea (P-value<0.05). Mild dysphonia was found in 10 (47.6%) of the dysphonic cases. The most common laryngoscopic finding was the bowing of the vocal cords (5/18). Most of the patients (11/18) were with dysphonia for more than a month duration. Similar numbers were not recovered for a one-month follow-up.

CONCLUSION: The prevalence of dysphonia was 22.3%. Dyspnea, fever, and cough were the commonest symptoms. Fatigue, nasal obstruction, and diarrhea affected dysphonia. Bowing of the vocal cords was the most common abnormality. Most of the cases were with mild dysphonia, persisting for more than a month, and were not resolved during the follow-up period of one month.

PMID:34246025 | DOI:10.1016/j.amjoto.2021.103157

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 28;263:261-274. doi: 10.1016/j.ejogrb.2021.06.036. Online ahead of print.

ABSTRACT

OBJECTIVE: To synthesize the evidence on Sertoli-Leydig cell tumour (SLCT) relapses, and identify the clinicopathological characteristics and prognosis of patients with recurrent SLCT.

METHODS: A literature search was undertaken of all published cases of SLCT relapse found in PubMed, Embase and Web of Science databases between January 1998 and January 2021. All articles in English reporting at least one case of SLCT relapse and mentioning the relapse location or the follow-up data were included. All reported data on relapsed cases were extracted. Student’s t-test and Chi-squared test were used for the descriptive analysis, and the Kaplan-Meier statistical method was applied for survival analysis.

RESULTS: Eighty-five patients from 33 articles were included in this review. The median age was 20 years (range 3-76 years) with a median time to relapse of 14 months (range 1-168 months). Forty-eight percent (36/75) of relapses were local and 52% (39/75) were distant. In the subgroup of conservative primary surgery, contralateral ovarian SLCT events (metachronous or recurrent) were more frequent in the paediatric population than in the adult population (58.3 vs 18.2%; p = 0.005). Eleven cases had multiple relapses. Twenty-one percent (12/57) of cases were treated with conservative surgery after recurrence, and 64.9% (37/57) of cases were treated with radical surgery which tends to have a better 2-year survival rate (78.5% vs 61.0%; p = 0.177). Overall median survival was 48 months after recurrence (95% confidence interval ±21.0 months) with overall 5-year survival of 38.9%. The mean survival time was significantly higher for patients diagnosed at an early stage (I and II) compared with patients diagnosed at an advanced stage (p = 0.003).

DISCUSSION: The results showed that SLCT relapses have a poor prognosis and occur mainly in young patients, soon after the initial diagnosis. The majority of SLCT relapses are located in the abdominopelvic region. Contralateral ovarian SLCT events (metachronous or recurrent) occurred more frequently in paediatric cases. Multi-modal treatment with surgery and chemotherapy appears to be the best approach. The best chemotherapeutic regimen has yet to be defined.

PMID:34245994 | DOI:10.1016/j.ejogrb.2021.06.036

Eur J Radiol. 2021 Jun 24;142:109832. doi: 10.1016/j.ejrad.2021.109832. Online ahead of print.

ABSTRACT

OBJECTIVES: Intramammary mass lesions are reportedly present in up to 5.8% of all contrast enhanced CT-examinations of the female chest. We aimed to assess whether their biological relevance can be estimated using spectral CT-datasets.

METHODS: In this bicentric retrospective study patients with breast masses visualized on spectral CT-examinations from 07/2017 to 06/2019 were included. Lesions were characterized as malignant or benign based on histology and/or a stable follow-up of >2 years. Conventional CT-images, iodine density-maps, virtual monoenergetic-images (40 keV, 100 keV) and Zeffective-maps were evaluated by two independent readers. Statistical analysis derived from the Regions of interest (ROIs) was done by calculating the Areas under the Receiver operating characteristic (ROC) curve (AUC) and Youden-indices.

RESULTS: 106 breast masses (malignant/benign: 81/25, 76.4%/23.6%) were included. The mean AUCs of the variables “iodine content” (reader 1/2:0.97;0.98), “monoenergetic curve-slope” (0.97;0.96) and “Zeffective” (0.98;0.98) measured in the target lesions (TL) showed superior results compared to those derived from the variable “density” (0.92;0.93) (p < 0.001). The ratios “TL to aorta” calculated for the variables “iodine content”, “monoenergetic curve-slope” and “Zeffective” showed superior results compared to normal breast tissue and muscle (p < 0.001). The optimal cutpoint for the “iodine content” in the TL was 0.7-0.9 mg/ml (sensitivity 96.6%, specificity 91.7%). The best diagnostic results were achieved by normalizing the iodine content in the TL to that in the aorta (optimal cutpoint 0.1, sensitivity 95.5%, 98.9%, specificity 91.7%).

CONCLUSIONS: Our preliminary results suggest that spectral CT-datasets might allow to estimate the biological dignity of breast masses detected on clinically indicated chest-examinations.

PMID:34246013 | DOI:10.1016/j.ejrad.2021.109832

Mult Scler Relat Disord. 2021 Jun 22;54:103092. doi: 10.1016/j.msard.2021.103092. Online ahead of print.

ABSTRACT

The management of multiple sclerosis (MS) has progressed significantly with the emergence of mHealth technologies. Uptake of mHealth apps amongst people with MS, and clinical and demographic characteristics of mHealth adopters is unknown outside North America. Participants of the HOLISM study were queried about their mHealth apps use. We summarize mHealth app usage, and clinical and demographic characteristics of mHealth app adopters using descriptive statistics. Overall, 3.1% of respondents reported using an mHealth app, most of whom were located in Australasia and North America. This study provides insight regarding mHealth app usage within a large international cohort of people with MS.

PMID:34246024 | DOI:10.1016/j.msard.2021.103092

BJU Int. 2021 Jul 10. doi: 10.1111/bju.15540. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVE: To minimize stent-related symptoms (SRS), a modified complete intra-ureteral stent with extraction suture was designed. The objective was to compare SRS of the conventional DJ stent and the complete intraureteral stent using the validated Ureteral Stent Symptom Questionnaire (USSQ).

MATERIALS AND METHODS: We randomized 124 patients after uncomplicated ureteroscopic lithotripsy into complete intraureteral stent (CIUS) and conventional DJ stent (CUS) placement group. The USSQ scores were evaluated on postoperative day 1, day 7 (just before stent removal) and 4 weeks after stent removal (control values). Pain scores after stent removal were also recorded using visual analogue scale (VAS). Sub-domain analysis of all stent related symptoms and stent related complications were also compared.

RESULTS: No significant intergroup differences were found in the domain scores of urinary symptoms (P = 0.74), pain (P = 0.32), general health (P = 0.27), work (P = 0.24), or additional problems (P = 0.29). However, statistically significant difference was noted on VAS scores (P = 0.015). Analysis of sub-domains of USSQ item scores revealed the CIUS group had significantly better scores for ”urge incontinence” (1.21 vs. 1.00; p = <0.001), ”discomfort on voiding” (2.07 vs. 1.50; p = <0.001), ”difficulties with respect to light physical activity” (1.131 vs. 1.00; p = <0.001), ”fatigue” (1.84 vs. 1.57; p = 0.002), “feeling comfortable” (3.68 vs. 3.16; p = 0.003), ”need for extra help” (1.96 vs. 1.00; p = <0.001), and ”change in duration of work”(4.27 vs. 1.86; p = <0.001). However, the patients in the CIUS group were sexually inactive for the time till stent was indwelling (mean: 7.34 days). There was no difference in the complication rate between the 2 groups.

CONCLUSION: The use of complete intra ureteral stent placement with strings after URS decreases SRS.

PMID:34245667 | DOI:10.1111/bju.15540

Mol Ecol. 2021 Jul 10. doi: 10.1111/mec.16071. Online ahead of print.

ABSTRACT

Humoral and cellular immune responses provide animals with major defenses against harmful pathogens. While it is often assumed that immune genes undergo rapid diversifying selection, this assumption has not been tested in many species. Moreover, it is likely that different classes of immune genes experience different levels of evolutionary constraint, resulting in varying selection patterns. We examined the evolutionary patterns for a set of 91 canonical immune genes of North American monarch butterflies (Danaus plexippus), using as an outgroup the closely related soldier butterfly (D. eresimus). As a comparison to these immune genes, we selected a set of control genes that were paired with each immune for approximate size and genomic location. As a whole, these immune genes had a significant but modest reduction in Tajima’s D relative to paired-control genes, but otherwise did not show distinct patterns of population genetic variation or evolutionary rates. When further partitioning these immune genes into four functional classes (recognition, signaling, modulation, and effector), we found distinct differences among these groups. Relative to control genes, recognition genes exhibit increased non-synonymous diversity and divergence, suggesting reduced constraints on evolution, and supporting the notion that coevolution with pathogens results in diversifying selection. In contrast, signaling genes showed an opposite pattern of reduced diversity and divergence, suggesting evolutionary constraints and conservation. Modulator and effector genes showed no statistical differences from controls. These results are consistent with patterns found in immune genes in fruit flies and Pieris butterflies, suggesting that consistent selective pressures on different classes of immune genes broadly govern the evolution of innate immunity among insects.

PMID:34245613 | DOI:10.1111/mec.16071

Oral Dis. 2021 Jul 10. doi: 10.1111/odi.13957. Online ahead of print.

ABSTRACT

OBJECTIVES: To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA) quantitatively compared the risk of bacteraemia triggered by dental extractions and home and professional cleaning procedures.

MATERIALS AND METHODS: Clinical trials with the outcome ‘bacteraemia in children’ were searched. The NMA was performed using the frequentist weighted least-squares approach comparing the odds ratios (OR) of different interventions.

RESULTS: Among 11 of 13 studies, dental treatment was performed under general anaesthesia. In 2,381 patients, bacteraemia occurred in 38.7-56% patients following single-tooth extractions, in 22-46% after manual toothbrushing (MTB), and in 26-78% after power toothbrushing (PTB). When MTB was set as the reference (OR 1), rubber cup polishing showed a slightly higher risk (OR 1.26) of bacteraemia. PTB presented a higher risk (OR 1.79-2.27) than with single-tooth extractions (OR 1.55) but lower than that with multiple extractions (OR 2.55).

CONCLUSION: Daily use of MTB and routine professional cleaning were associated with the lowest risk of developing bacteraemia in children with gingivitis, almost as much as with a single-tooth extractions. Improved plaque control with PTB increased the risk of bacteraemia. There is limited evidence on gingivitis-free and systemically-diseased children.

PMID:34245644 | DOI:10.1111/odi.13957

J Neurosci Res. 2021 Jul 10. doi: 10.1002/jnr.24912. Online ahead of print.

ABSTRACT

In athletes, long-term intensive training has been shown to increase unparalleled athletic ability and might induce brain plasticity. We evaluated the structural connectome of world-class gymnasts (WCGs), as mapped by diffusion-weighted magnetic resonance imaging probabilistic tractography and a multishell, multitissue constrained spherical deconvolution method to increase the precision of tractography at the tissue interfaces. The connectome was mapped in 10 Japanese male WCGs and in 10 age-matched male controls. Network-based statistic identified subnetworks with increased connectivity density in WCGs, involving the sensorimotor, default mode, attentional, visual, and limbic areas. It also revealed a significant association between the structural connectivity of some brain structures with functions closely related to the gymnastic skills and the D-score, which is used as an index of the gymnasts’ specific physical abilities for each apparatus. Furthermore, graph theory analysis demonstrated the characteristics of brain anatomical topology in the WCGs. They displayed significantly increased global connectivity strength with decreased characteristic path length at the global level and higher nodal strength and degree in the sensorimotor, default mode, attention, and limbic/subcortical areas at the local level as compared with controls. Together, these findings extend the current understanding of neural mechanisms that distinguish WCGs from controls and suggest brain anatomical network plasticity in WCGs resulting from long-term intensive training. Future studies should assess the contribution of genetic or early-life environmental factors in the brain network organization of WCGs. Furthermore, the indices of brain topology (i.e., connection density and graph theory indices) could become markers for the objective evaluation of gymnastic performance.

PMID:34245603 | DOI:10.1002/jnr.24912