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Nevin Manimala Statistics

Safety of laparoscopic surgery during pregnancy: a Korean nationwide population-based study

Surg Endosc. 2022 Mar 18. doi: 10.1007/s00464-022-09188-9. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal surgical approach to perform during pregnancy is still controversial. This study evaluated pregnancy and operative outcomes in women undergoing an appendectomy or cholecystectomy during pregnancy, and compared them between the laparoscopic and open approach using nationwide population-based data.

METHODS: Between 2009 and 2019, a total of 2941 pregnant women with procedure codes for an appendectomy or cholecystectomy were extracted from the Korean National Health Insurance claims data (laparoscopy: 1504; open: 1437). Surgical outcomes [length of stay (LOS), anesthesia time, 30-day readmission rates, transfusion rates, second laparotomy, and 30-day mortality rates] and pregnancy outcomes (live birth rate, overall and spontaneous abortion rates, threatened abortion rate, type of delivery, preterm labor, stillbirth, fetal screening abnormalities, and intrauterine growth retardation) were compared between the open and laparoscopic groups.

RESULTS: The laparoscopic group had a significantly shorter LOS than the open group, and transfusions were less frequent in the laparoscopic group. Mortality, 30-day readmission rates, and second laparotomy were not statistically significant between the two groups. There were no significant differences in fetal loss and live birth rates between the two groups in all gestational ages. Preterm labor within 30 days of surgery was more frequent in the laparoscopy group than in the open surgery group, especially for those in their first and third trimesters. Open procedures were associated with an increased rate of cesarean sections.

CONCLUSIONS: Laparoscopic surgery was found to be feasible and safe without adverse postoperative outcomes. Careful observation of postoperative preterm labor is necessary, especially for women who undergo laparoscopic surgery in their first and third trimesters.

PMID:35304619 | DOI:10.1007/s00464-022-09188-9

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Application of fingernail samples as a biomarker for human exposure to arsenic-contaminated drinking waters

Sci Rep. 2022 Mar 18;12(1):4733. doi: 10.1038/s41598-022-08845-2.

ABSTRACT

This study evaluated the relationship between arsenic uptake via drinking water ingestion and arsenic concentration in fingernails as a biomarker for human exposure. For this purpose, we collected fingernail samples from 40 healthy participants of arsenic-affected rural regions of Kaboudrahang County, the west of Iran. A total of 49 fingernail samples were also collected from individuals who lived in areas where contamination of drinking water sources with arsenic had not been reported. It was found that the fingernails arsenic contents in 50 and 4.08% of the samples collected from arsenic-contaminated and reference villages were higher than the normal arsenic values of nails (0.43-1.08 µg/g), respectively. Based on the results of adjusted multiple linear regression, a significant association was found between groundwater and fingernails arsenic concentration (p < 0.001). Moreover, a statistically significant association was shown between arsenic in the fingernail samples and gender (p = 0.037). Fingernails arsenic contents were not significantly affected by other variables including age, smoking habits, and BMI (p > 0.05). In light of the results of this study, the use of biological indicators such as fingernail tissues due to easier sampling and less risk of external contamination is suitable for assessing exposure to heavy metals in contaminated areas.

PMID:35304571 | DOI:10.1038/s41598-022-08845-2

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Short-term comparison between navigated subthreshold microsecond pulse laser and oral eplerenone for chronic central serous chorioretinopathy

Sci Rep. 2022 Mar 18;12(1):4727. doi: 10.1038/s41598-022-08764-2.

ABSTRACT

To compare the anatomical/functional changes after navigated subthreshold pulse laser (SML) and oral eplerenone therapy for chronic central serous chorioretinopathy (cCSC). A total of 36 eyes of 36 patients suffering from cCSC treated with navigated SML (Navilas® 577s; OD-OS GmbH, near Berlin, Germany) (18 eyes, SML group) and oral eplerenone (18 eyes, eplerenone group) were enrolled in this retrospective study. Main outcome measures during a 3-month follow up period included changes of best corrected visual acuity (BCVA), central macular thickness (CMT), foveal subretinal fluid thickness (FSRFT), and subfoveal choroidal thickness (SFCT). At baseline average duration of symptoms was 6.8 ± 0.6 months in SML group and 6.4 ± 0.9 months in eplerenone group (p = 0.127). Mean BCVA, CMT and FSRFT changed significantly over time (p < 0.001). From baseline to 90 days the BCVA improved from 0.3 ± 0.1 to 0.1 ± 0.1 logMAR in SML group and from 0.3 ± 0. to 0.2 ± 0.1 logMAR in eplerenone group, CMT reduced from 357.1 ± 104.3 to 210.6 ± 46.7 μm and from 428.7 ± 107.7 to 332.5 ± 27.5 μm in SML group and eplerenone group respectively, FSRFT reduced from 144.4 ± 108.2 to 22.6 ± 37.2 μm and from 217.1 ± 105.9 to 54.4 ± 86.2 μm in SML group and eplerenone group. 55.6% of patients in SML group and 66.7% in eplerenone group showed a complete resolution of FSRFT during follow up. The interaction between group and time was statistically significant with greater absolute variation for CMT and FSRFT in SML group compared to eplerenone group (p < 0.001 and p = 0.043). SFCT did not change significantly during follow up (p = 0.083) for both groups. Both navigated SML and oral eplerenone were effective treatments showing recovery of retinal morphology and related visual acuity improvement in cCSC.

PMID:35304566 | DOI:10.1038/s41598-022-08764-2

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Machine perfusion combined with antibiotics prevents donor-derived infections caused by multidrug-resistant bacteria

Am J Transplant. 2022 Mar 18. doi: 10.1111/ajt.17032. Online ahead of print.

ABSTRACT

Donor infection affects organ utilization, especially the infections by multidrug-resistant bacteria, which may have disastrous outcomes. We established a rat model, inoculated with Escherichia coli (E. coli) or carbapenem-resistant Klebsiella pneumoniae (CRKP), to investigate whether hypothermic machine perfusion (HMP), normothermic machine perfusion (NMP), or static cold storage (SCS) combined with antibiotic (AB) could eliminate the bacteria. E. coli or CRKP-infected kidneys were treated with cefoperazone-sulbactam and tigecycline, respectively. The HMP+AB and NMP+AB treatments had significant therapeutic effects on E. coli or CRKP infection compared with the SCS+AB treatment. The bacterial load of CRKP-infected kidneys in the HMP+AB (22050±2884 CFU/g vs. 1900±400 CFU/g, p=0.007) and NMP+AB groups (25433±2059 CFU/g vs. 500±458 CFU/g, p=0.002) were significantly reduced, with no statistically significant difference between both groups. Subsequently, the CRKP-infected kidneys of the HMP+AB and SCS+AB groups were transplanted. The rats in the SCS+AB group were severe infected and euthanized on day 4 post-transplant. By contrast, the rats in the HMP+AB group were in good condition. In conclusion, HMP and NMP combined with AB seems to be efficient approaches to decrease bacterial load of infected kidneys. This might lead to higher utilization rates of donors with active infection.

PMID:35303398 | DOI:10.1111/ajt.17032

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Does fast-food outlet density differ by area-level disadvantage in metropolitan Perth, Western Australia?

Health Promot J Austr. 2022 Mar 18. doi: 10.1002/hpja.597. Online ahead of print.

ABSTRACT

ISSUE ADDRESSED: Socio-economic spatial patterning of fast-food outlets can result in disparities in the availability and access of food across geographic areas, contributing to health inequalities. This study investigated whether area-level socio-economic disparities exist in fast-food availability across the Perth metropolitan region of Western Australia.

METHODS: Fast-food outlet locations were sourced from Perth Local Governments in 2018/2019. All Perth suburbs (n=328) were allocated a decile ranking based on the Australian Bureau of Statistics Socio-Economic Index for Areas with decile 1 indicating relatively greater disadvantage and decile 10 indicating a relative lack of disadvantage. Zero-inflated negative binomial regression models, adjusted for suburb area and population density, were used to investigate the association between area-level disadvantage decile and availability of fast-food outlets.

RESULTS: A socio-economic gradient was identified; for every unit increase in disadvantage decile (i.e., a reduction in relative disadvantage), the count of fast-food outlets decreased by 6% (p<0.01), and the count of the “top ranking” fast-food chains (i.e., McDonalds, KFC, Hungry Jacks and Red Rooster) decreased by 10% (p < 0.001).

CONCLUSIONS: Consistent with evidence internationally and from within Australia, socio-economic spatial patterning of fast-food outlet availability was shown to exist in Perth, with greater fast-food availability in areas with more relative socio-economic disadvantage. SO WHAT?: To address health inequities associated with fast-food consumption, policy and practice changes are needed that manage fast-food outlet proliferation in areas of greater socio-economic disadvantage.

PMID:35303384 | DOI:10.1002/hpja.597

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The effect of Intravenous ferric-carboxymaltose on right ventricular function – insights from the IRON-CRT trial

Eur J Heart Fail. 2022 Mar 18. doi: 10.1002/ejhf.2489. Online ahead of print.

ABSTRACT

BACKGROUND: Ferric carboxymaltose (FCM) improves left ventricular (LV) function in heart failure with reduced ejection fraction (HFrEF). Yet, the effect of FCM on right ventricular (RV) function remains insufficiently elucidated.

METHODS: This is a predefined analysis of the IRON-CRT trial in which symptomatic HFrEF patients with iron deficiency and reduced LV ejection (LVEF) despite optimal medical therapy and cardiac resynchronization therapy (CRT) underwent 1:1-randomization to FCM or placebo in a double blind fashion. RV function was measured as the change from baseline to 3-month follow-up of RV fractional area change (FAC), TAPSE and RV S’, systolic pulmonary artery pressure (SPAP) and its coupling to the RV (TAPSE/SPAP-ratio). The RV-contractile reserve was measured as the change in TAPSE during incremental pacing at 70, 90 and 110 Bpm.

RESULTS: A total of 75 patients underwent randomization and received FCM(n= 37) or placebo(n=38). At baseline 72.5% had RV dysfunction and 70% had RV dilatation. At 3-month follow-up patients receiving FCM had a significant improvement in RV FAC (Placebo=-2.2%[-4.9%-+0.6%] vs FCM=+4.1%[+1.4%-+6.9%], p=0.002) and TAPSE (placebo=-0.19mm[-0.85mm-+0.48mm] vs FCM=+0.98mm[+0.28mm-+1.62mm], p=0.020), but not RV S’. Patients receiving FCM had a numerically lower SPAP (p=0.073) and significant improvement in TAPSE/SPAP-ratio (placebo= +0.002[-0.046-+0.051] vs FCM= +0.097[+0.048-+0.146], p=0.008). At baseline both groups had diminished RV-contractile reserve during incremental pacing, which was attenuated at 3-month follow-up in the FCM group (p=0.004). Patients manifesting more RV function improvement were more likely to exhibit higher degrees of LVEF-improvement (p<0.05 for all).

CONCLUSIONS: Treatment with FCM in HFrEF patients results in an improvement in RV function and structure and improves the RV-contractile reserve.

PMID:35303390 | DOI:10.1002/ejhf.2489

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Clinical effects of maxillary protraction in different stages of dentition in skeletal class III children: a systematic review and meta-analysis

Orthod Craniofac Res. 2022 Mar 18. doi: 10.1111/ocr.12569. Online ahead of print.

ABSTRACT

OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the effectiveness of using maxillary protraction during different stages of the dentition by assessing changes in the jaws and inclination of incisors.

MATERIALS AND METHODS: MEDLINE (PubMed), Embase, Cochrane, Web Of Science, China National Knowledge Infrastructure, and Wanfang Databases were searched without time limitations up to the 15th January 2022. Google Scholar was used to search grey literature. We included cohort studies that compared the effect of maxillary protraction by analyzing primary outcomes and were grouped in age-related conditions. Mean differences and 95% confidence intervals were used for statistical analysis, followed by Grading of Recommendations Assessment, Development and Evaluation analysis.

RESULTS: Six studies were finally included. The heterogeneity test showed P≥0.1 and I2 ≤50%, and a fixed-effect model was applied. Patients in the early treatment group (ETG) were mainly in the early-mixed dentition stage, while patients in the late-treatment group (LTG) were in the late-mixed and early-permanent dentition stage. Meta-analysis showed that there were no statistical differences (P>0.05) between the ETG and LTG groups in terms of SNA (the angle composed by point Sella-Nasion-Subspinale), SNB (the angle composed by point Sella-Nasion-Supramentale), ANB (the angle composed by point Subspinale-Nasion-Supramentale), Wits, U1/SN (the angle composed by the axis of upper incisors and Sella-Nasion plane), and L1/MP (the angle composed by the axis of lower incisors and the mandibular plane).

CONCLUSION: Our analysis showed that maxillary protraction applied in the late-mixed or early-permanent dentition stage did not cause different effects on the maxillary growth, the correction of the intermaxillary relationship, the inhibition of mandibular growth, and dental tipping of skeletal class III patients when compared with that in the early-mixed dentition stage. Collectively, these data provide a theoretical basis for widening the applicable age period of maxillary protraction and choosing the best treatment opportunity for children patients after a comprehensive assessment.

PMID:35303382 | DOI:10.1111/ocr.12569

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Insight into dominant intestinal microbiota and the fatty acids profile of turkeys following the administration of synbiotic preparations

J Sci Food Agric. 2022 Mar 18. doi: 10.1002/jsfa.11881. Online ahead of print.

ABSTRACT

BACKGROUND: Probiotics and prebiotics are widely used as natural feed additives in the nutrition of farm animals, including poultry. The using of this type of preparations has a positive effect on animal welfare, human health and the environment. High potential is attributed to preparations combining probiotics and prebiotics, called synbiotics. The aim of the research was to confirm the beneficial effects of synbiotics on turkey’s performance and the number of dominant intestinal microbiota. In addition, we also investigated the concentration of organic acids (lactic acid, fatty acids: short chain – SCFA and branched chain – BCFA) in the excreta of turkeys.

RESULTS: The synbiotic supplementation of turkey’s caused statistically significant (P < 0.05) differences in body weight of animals and European Production Efficiency Factor (EPEF) compared to control group after 15 weeks of rearing. The administration of the synbiotics resulted in a significant (P < 0.05) reduction in the count of potential pathogens (Clostridium spp., Clostridium coccoides and Escherichia coli), while a significant (P < 0.05) increase in the count of beneficial microorganisms (lactobacilli and Bifidobacterium spp.) in the excreta of turkeys. Result of the synbiotic supplementation, the SCFAs and lactic acid concentration were significantly (P < 0.05) increased, while the BCFAs concentration were decreased.

CONLUSION: The results showed a beneficial influence of the synbiotics on the animal’s performance, the dominant intestinal microbiota, and the fatty acids profile in the excreta of turkeys. The developed synbiotics can be effectively used in turkey’s nutrition. This article is protected by copyright. All rights reserved.

PMID:35303378 | DOI:10.1002/jsfa.11881

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Analysis of the impact of badger culling on bovine tuberculosis in cattle in the high-risk area of England, 2009-2020

Vet Rec. 2022 Mar;190(6):e1384. doi: 10.1002/vetr.1384.

ABSTRACT

BACKGROUND: Since 2013, badger culling has been part of the UK Government’s strategy for controlling bovine tuberculosis (bTB) within a high-risk area (HRA) in England. Government surveillance data now enables an examination of bTB herd incidence and prevalence, its headline indicators, within and outside cull areas over the period 2009-2020.

METHODS: Analysis compared herd incidence and prevalence data from within and outside badger culling areas. A range of models (GLMs, GLMMs, GAMs and GAMMs) were used to analyse incidence and prevalence in culled and unculled areas using frequentist and Bayesian approaches. Change in incidence across ten county areas within the HRA for the period 2010-2020 was also compared.

RESULTS: Analyses based on Defra published data using a variety of statistical methodologies did not suggest that badger culling affected herd bTB incidence or prevalence over the study period. In 9 of 10 counties, bTB incidence peaked and began to fall before badger culling commenced.

LIMITATIONS: There are limitations around the data available on culling location, temporal information and other confounding factors. As such, further analysis of any future datasets that may be released on bTB levels in areas where badger culling has been implemented is warranted.

CONCLUSION: This examination of government data obtained over a wide area and a long time period failed to identify a meaningful effect of badger culling on bTB in English cattle herds. These findings may have implications for the use of badger culling in current and future bTB control policy.

PMID:35303326 | DOI:10.1002/vetr.1384

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Intensive Chemotherapy for Acute Myeloid Leukemia Relapse after Allogeneic Hematopoietic Cell Transplantation

Am J Hematol. 2022 Mar 18. doi: 10.1002/ajh.26540. Online ahead of print.

NO ABSTRACT

PMID:35303371 | DOI:10.1002/ajh.26540