Tag: pubmed

Injury. 2021 Feb 18:S0020-1383(21)00152-2. doi: 10.1016/j.injury.2021.02.049. Online ahead of print.

ABSTRACT

INTRODUCTION: . Early hip fracture surgery (<48 hours) has shown to improve mortality for geriatric patients and is recommended in national hip fracture guidelines. However, this may be at the expense of surgery being performed out-of-hours where concerns about mortality risk exist. A systematic review and meta-analysis were performed to determine the mortality risk for hip fracture surgery performed in-hours (IH) compared to out-of-hours (OH), and on weekdays (WD) compared to weekends (WE).

MATERIALS AND METHODS: . A systematic search of literature in the databases of MEDLINE, PubMed, Embase and Cochrane from the dates of inception was performed. All studies published in English were included. Risk of Bias in Non-randomised Studies (ROBINS-I) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework were utilised. Relative risk (RR) was used for dichotomous outcomes, while mean difference (MD) was used for continuous variables, with 95% confidence intervals. Alpha was set at 0.05.

RESULTS: . A total of 13 studies with 177,090 patients were included for analysis. Overall, there was no statistically significant difference for 30-day or inpatient mortality in IH vs OH groups (RR 0.93, p=0.46 and RR 1.16, p=0.63) and for WD vs WE groups (RR 0.98, p=0.73 and RR 0.76, p=0.67). There was no difference in length of stay between groups (p>0.05). The number of patients with American Society of Anaesthesiology (ASA) physical status classification ≥3 and male gender between the groups were similar (p>0.05).

CONCLUSION: . Performing hip fracture surgery OH or on the WE does not appear to increase the risk of 30-day or inpatient mortality or post-operative complications. Consideration should be given to performing hip fracture surgery out-of-hours to meet national guidelines (<48 hours).

PMID:33648740 | DOI:10.1016/j.injury.2021.02.049

Br J Anaesth. 2021 Feb 26:S0007-0912(21)00077-5. doi: 10.1016/j.bja.2021.02.001. Online ahead of print.

NO ABSTRACT

PMID:33648702 | DOI:10.1016/j.bja.2021.02.001

Clin Exp Reprod Med. 2021 Mar;48(1):61-68. doi: 10.5653/cerm.2020.03965. Epub 2021 Feb 17.

ABSTRACT

OBJECTIVE: This study was conducted to investigate the relationship of semen parameters in samples used for intracytoplasmic sperm injection (ICSI) with fertilization and pregnancy rates in infertile couples.

METHODS: In this prospective study of Infertile couples with male factor infertility that had undergone ICSI, fractions of the same semen samples obtained for microinjection (to ensure the best predictability) were evaluated to determine the semen parameters and sperm DNA fragmentation index (DFI) on the day of oocyte recovery.

RESULTS: In total, 120 couples completed the study and were subdivided into fertilized (n=87) and non-fertilized couples (n=33). The fertilized couples were further classified into pregnant (n=48) and non-pregnant (n=39) couples. Compared to non-fertilized and non-pregnant couples, fertilized and pregnant couples showed statistically significantly higher sperm viability and percentage of normal sperm morphology, as well as significantly lower sperm DFI values. A receiver operating characteristic curve analysis of data from the 120 ICSI cycles showed that sperm viability, normal sperm morphology percentages, and sperm DFI were significant prognostic indicators of fertilization at cutoff values of 40%, 7%, and 46%, respectively. A sperm DFI of 46% showed sensitivity and specificity of 95% and 90%, respectively, for predicting fertilization, and no clinical pregnancies occurred in couples with a sperm DFI above 46%.

CONCLUSION: Semen parameters from the ICSI day sample, especially sperm viability, normal morphology, and DFI, had an impact on fertilization and pregnancy outcomes in ICSI cycles.

PMID:33648046 | DOI:10.5653/cerm.2020.03965

J Health Polit Policy Law. 2021 Feb 22:8893515. doi: 10.1215/03616878-8893515. Online ahead of print.

ABSTRACT

CONTEXT: Understanding the role of drug-related issues in political campaign advertising can provide insight on the salience of this issue and the priorities of candidates for elected office. This study sought to quantify the share of campaign advertising mentioning drugs in the 2012 and 2016 election cycles and to estimate the association between local drug overdose mortality and drug mentions in campaign advertising across US media markets.

METHODS: The analysis used descriptive and spatial statistics to examine geographic variation in campaign advertising mentions of drugs across all 210 US media markets, and it used multivariable regression to assess area-level factors associated with that variation.

FINDINGS: The share of campaign ads mentioning drugs grew from 0.5% in the 2012 election cycle to 1.6% in the 2016 cycle. In the 2016 cycle, ads airing in media markets with overdose mortality rates in the 95th percentile were more than three times as likely to mention drugs as ads airing in areas with overdose mortality rates in the 5th percentile.

CONCLUSIONS: A small proportion of campaign advertising mentioned drug-related issues. In the 2016 cycle, the issue was more prominent in advertising in areas hardest hit by the drug overdose crisis and in advertising for local races.

PMID:33647977 | DOI:10.1215/03616878-8893515

J Reconstr Microsurg. 2021 Mar 1. doi: 10.1055/s-0041-1723816. Online ahead of print.

ABSTRACT

BACKGROUND: Approximately half of all patients presenting for autologous breast reconstruction have abdominal scars from prior surgery, the presence of which is considered by some a relative contraindication for abdominally based reconstruction. This meta-analysis examines the impact of prior abdominal surgery on the complication profile of breast reconstruction with abdominally based free tissue transfer.

METHODS: Literature search was conducted using PubMed, Scopus, and Web of Science. Included studies examined patients with a history of prior abdominal surgery who then underwent abdominally based free flap breast reconstruction. Prior liposuction patients and those with atypical flap designs were excluded. The Newcastle-Ottawa Scale was used to assess study quality. Flap complications included total and partial flap loss, fat necrosis, infection, and reoperation. Donor-site complications included delayed wound healing, infection, seroma, hematoma, and abdominal wall morbidity (hernia, bulge, laxity). Relative risk and 95% confidence intervals (CIs) between groups were calculated. Forest plots, I ² statistic heterogeneity assessments, and publication bias funnel plots were produced. Publication bias was corrected with a trim-and-fill protocol. Overall effects were assessed by fixed-effects and random-effects models.

RESULTS: After inclusion and exclusion criteria were applied, 16 articles were included for final review. These included 14 cohort and 2 case-control studies, with 1,656 (46.3%) patients and 2,236 (48.5%) flaps having undergone prior surgery. Meta-analysis showed patients with prior abdominal surgery were significantly more likely to experience donor-site delayed wound healing with a risk ratio of 1.27 (random 95% CI [1.00; 1.61]; I ²= 4) after adjustment for publication bias. No other complications were statistically different between groups.

CONCLUSION: In patients with a history of prior abdominal surgery, abdominally based free tissue transfer is a safe and reliable option. Abdominal scars may slightly increase the risk of delayed donor-site wound healing, which can aid the surgeon in preoperative counseling.

PMID:33648009 | DOI:10.1055/s-0041-1723816

Pediatr Obes. 2021 Mar 1:e12781. doi: 10.1111/ijpo.12781. Online ahead of print.

ABSTRACT

BACKGROUND: There are concerns that fruit juice and milk contribute to childhood obesity.

OBJECTIVE: Determine the relationship between fruit juice and milk intakes and body mass index (BMI) change among preadolescents/adolescents.

METHODS: Participants aged 9 to 16 years old from the Growing Up Today Study II completed surveys including validated food frequency questionnaires in 2004, 2006 and 2008. The contributions of one serving of juice or milk to total energy intake and 2-year change in BMI were evaluated using multiple linear regression. Additional analyses were conducted with subgroups of juice (orange juice and other fruit juice) and milk (low fat and high fat). Missing values for BMI were imputed using a multiple imputation approach, after which data from 8173 participants and 13 717 2-year interval observations were analysed.

RESULTS: Baseline fruit juice consumption was inversely associated with BMI change in girls (β = -.102 kg/m² , SE = 0.038, P value = .008) but not boys after controlling for race, age, baseline BMI, and baseline and 2-year changes in total energy intake and physical activity. Orange juice was inversely associated with BMI change among girls (β = -.137 kg/m² , SE = 0.053, P value = .010) while other fruit juice, low fat and high fat milk were not associated with BMI change.

CONCLUSION: Orange juice was inversely associated with 2-year BMI change among preadolescent/adolescent girls but not boys and there were no significant associations with other juices or milk among either gender.

PMID:33648027 | DOI:10.1111/ijpo.12781

Aesthet Surg J. 2021 Feb 27:sjaa388. doi: 10.1093/asj/sjaa388. Online ahead of print.

ABSTRACT

BACKGROUND: Results from the MemoryGel Breast Implants Core Clinical Study suggest these devices are safe and effective at 10 years after implantation. Although clinical trials are essential for measuring the safety and effectiveness of a device, real-world evidence can supplement clinical trials by providing information on outcomes observed in diverse clinical settings for a more heterogeneous population, without fixed treatment patterns, and without continuous patient monitoring, such that follow-up is more representative of normal clinical practice.

OBJECTIVES: The aim of this study was to measure real-world outcomes, including safety and effectiveness, in patients who underwent primary breast augmentation with smooth MemoryGel implants.

METHODS: This was a case series looking at patients, age 22 years and older, who underwent primary breast augmentation at a single site between December 2006 and December 2016 and who had a minimum of 2 years of follow-up. Descriptive statistics were used to summarize baseline characteristics and outcomes. Kaplan-Meier models were used to estimate safety outcomes for capsular contracture (Baker grade III/IV), infection, and rupture.

RESULTS: A total of 50/777 (6.4%) patients reported a complication, with an average time to complication of 3.9 years (range, 19 days-11.8 years) postprocedure. Kaplan-Meier estimates of the 10-year cumulative incidence of capsular contracture (Baker grade III/IV), infection, and rupture were 4.7%, 0.1%, and 1.6%, respectively.

CONCLUSIONS: Analyses of a large population from a single site provide further support for the long-term safety and effectiveness of MemoryGel breast implants in a primary augmentation cohort.

PMID:33647937 | DOI:10.1093/asj/sjaa388

Eur Heart J. 2021 Feb 27:ehab110. doi: 10.1093/eurheartj/ehab110. Online ahead of print.

ABSTRACT

BACKGROUND : Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) still reaches excessively high mortality rates. This analysis is aimed to develop a new easily applicable biomarker-based risk score.

METHODS AND RESULTS : A biomarker-based risk score for 30-day mortality was developed from 458 patients with CS complicating AMI included in the randomized CULPRIT-SHOCK trial. The selection of relevant predictors and the coefficient estimation for the prognostic model were performed by a penalized multivariate logistic regression analysis. Validation was performed internally, internally externally as well as externally in 163 patients with CS included in the randomized IABP-SHOCK II trial. Blood samples were obtained at randomization. The two trials are registered with ClinicalTrials.gov (NCT01927549 and NCT00491036), are closed to new participants, and follow-up is completed. Out of 58 candidate variables, the four strongest predictors for 30-day mortality were included in the CLIP score (cystatin C, lactate, interleukin-6, and N-terminal pro-B-type natriuretic peptide). The score was well calibrated and yielded high c-statistics of 0.82 [95% confidence interval (CI) 0.78-0.86] in internal validation, 0.82 (95% CI 0.75-0.89) in internal-external (temporal) validation, and 0.73 (95% CI 0.65-0.81) in external validation. Notably, it outperformed the Simplified Acute Physiology Score II and IABP-SHOCK II risk score in prognostication (0.83 vs 0.62; P < 0.001 and 0.83 vs. 0.76; P = 0.03, respectively).

CONCLUSIONS : A biomarker-only score for 30-day mortality risk stratification in infarct-related CS was developed, extensively validated and calibrated in a prospective cohort of contemporary patients with CS after AMI. The CLIP score outperformed other clinical scores and may be useful as an early decision tool in CS.

PMID:33647946 | DOI:10.1093/eurheartj/ehab110

Bioinformatics. 2021 Feb 27:btab136. doi: 10.1093/bioinformatics/btab136. Online ahead of print.

ABSTRACT

MOTIVATION: Many recent advancements in single molecule localisation microscopy exploit the stochastic photo-switching of fluorophores to reveal complex cellular structures beyond the classical diffraction limit. However, this same stochasticity makes counting the number of molecules to high precision extremely challenging, preventing key insight into the cellular structures and processes under observation.

RESULTS: Modelling the photo-switching behaviour of a fluorophore as an unobserved continuous time Markov process transitioning between a single fluorescent and multiple dark states, and fully mitigating for missed blinks and false positives, we present a method for computing the exact probability distribution for the number of observed localisations from a single photo-switching fluorophore. This is then extended to provide the probability distribution for the number of localisations in a dSTORM experiment involving an arbitrary number of molecules. We demonstrate that when training data is available to estimate photoswitching rates, the unknown number of molecules can be accurately recovered from the posterior mode of the number of molecules given the number of localisations. Finally, we demonstrate the method on experimental data by quantifying the number of adapter protein Linker for Activation of T cells (LAT) on the cell surface of the T cell immunological synapse.

AVAILABILITY: Software available at https://github.com/lp1611/mol_count_dstorm.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:33647949 | DOI:10.1093/bioinformatics/btab136

Cancer Treat Res Commun. 2021 Feb 24;27:100343. doi: 10.1016/j.ctarc.2021.100343. Online ahead of print.

ABSTRACT

BACKGROUND: No large-scale study evaluating the usefulness of tamoxifen after meningioma surgery has been undertaken.

METHODS: We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve cases of meningiomas operated between 2007 and 2017. Survival analyses were performed using a matched cohort study.

RESULTS: 251 patients treated by tamoxifen were extracted from a nationwide population-based cohort of 28 924 patients operated on for a meningioma over a 10-year period. 94% were female and median age at meningioma first surgery was 57 years IQR[47-67]. Tamoxifen treatment median duration was 1.4 years IQR[0.4-3.2]. Tamoxifen treatment median cumulative given dose was 11.4 gs, IQR[3.6-24.9]. There was a strong positive correlation between treatment duration and cumulative dose (τ=0.81, p<0.001). 6% of the patient had to be reoperated for a meningioma recurrence and 26.3% had radiotherapy. OS rates at 5 and 10 years were: 92.3%, _95%CI[90.3-94.3] and 81.3%, _95%CI[75.2-88] respectively. These 251 patients were matched by gender, age at surgery and grade with the same number of subjects within the nationwide cohort. Nor overall (HR=1.46, _95%CI[0.86- 2.49], p=0.163) or progression-free survival (HR=1.2, _95%CI[0.89- 1.62], p=0.239) were significantly improved by the tamoxifen treatment.

CONCLUSION: Using this unique database, in the setting of breast cancer, we could not conclude on a favourable effect of tamoxifen to prevent recurrence after meningioma surgery or to increase meningioma-related survival even in case of prolonged treatment duration or high cumulative given dose.

PMID:33647870 | DOI:10.1016/j.ctarc.2021.100343