Tag: statistics

Environ Mol Mutagen. 2022 Apr 25. doi: 10.1002/em.22483. Online ahead of print.

ABSTRACT

Ionizing radiation is a well-appreciated health risk, precipitant of DNA damage, and contributes to DNA methylation variability. Nevertheless, relationships of ionizing radiation with DNA methylation-based markers of biological age (i.e. epigenetic clocks) remain poorly understood. Using existing data from human bronchial epithelial cells, we examined in vitro relationships of three epigenetic clock measures (Horvath DNAmAge, MiAge, and epiTOC2) with galactic cosmic radiation (GCR), which is particularly hazardous due to its high linear energy transfer (LET) heavy ion components. High-LET 56Fe was significantly associated with accelerations in epiTOC2 (β=192 cell divisions, 95%CI: 71, 313, P-Value=0.003). We also observed a significant, positive interaction of 56Fe ions and time-in-culture with epiTOC2 (95%CI: 42, 441, P-Value=0.019). However, only the direct 56Fe ion association remained statistically significant after adjusting for multiple hypothesis testing. Epigenetic clocks were not significantly associated with high-LET 28Si and low-LET xrays. Our results demonstrate sensitivities of specific epigenetic clock measures to certain forms of GCR. These findings suggest that epigenetic clocks may have some utility for monitoring and better understanding the health impacts of GCR. This article is protected by copyright. All rights reserved.

PMID:35470505 | DOI:10.1002/em.22483

J Gastroenterol Hepatol. 2022 Apr 25. doi: 10.1111/jgh.15870. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Percutaneous endoscopic gastrostomy (PEG) placement is recommended in patients with amyotrophic lateral sclerosis (ALS), but the procedure is considered high risk. In this study, we aimed to compare the outcome of ALS patients with and without PEG. The success of the procedure and complications of PEG insertion were also explored.

METHODS: Patients with ALS who met the criteria for enteral feeding support were consecutively recruited. Patients who consented had PEG insertion using the modified technique of introducer method with transoral ultra-slim endoscopy.

RESULTS: A total of 64 patients were recruited, of which 36 (56%) patients consented to PEG. The median age of all patients was 65 years and 59% were male. There was no difference in demographic and clinical characteristics between patients who agreed to a PEG and those who did not. The mortality rate at 6 and 12 months was lower in the PEG cohort compared with non-PEG, but this was not statistically significant (6 months: 28.6% vs 32.2%, P = 0.561; 12 months: 38.9% vs 50.0%, P = 0.374). Amongst the PEG cohort, 61% were stratified high risk and 31% moderate risk. Thirty-one percent of them required long-term home noninvasive ventilation. All patients (100%) underwent successful PEG insertion at single attempt using the modified approach. The complications reported over a period of 6 months were infected PEG site (17%), dislodged gastrostomy tube (14%), and minor bleeding (8%).

CONCLUSION: In ALS patients with moderate to high risk of PEG insertion, the introducer technique utilizing ultra-slim endoscopy guidance was well tolerated and safe.

PMID:35470471 | DOI:10.1111/jgh.15870

Int Endod J. 2022 Apr 26. doi: 10.1111/iej.13754. Online ahead of print.

ABSTRACT

AIM: The addition of etidronic acid (HEDP) to sodium hypochlorite (NaOCl) could increase the antibiofilm potency of the irrigant, while maintaining the benefits of continuous chelation. Studies conducted so far have shown that mixing HEDP with NaOCl solutions of relatively low concentration does not compromise the antibiofilm efficacy of the irrigant. However, the working lifespan of NaOCl may decrease resulting in a reduction of its antibiofilm efficacy over time (efficiency). In this regard, continuous irrigant replenishment needs to be examined. This study investigated the response of a dual-species biofilm when challenged with 2% and 5% NaOCl mixed with HEDP for a prolonged timespan and under steady laminar flow.

METHODOLOGY: Dual-species biofilms comprised of Streptococcus oralis J22 and Actinomyces naeslundii T14V-J1 were grown on human dentine discs in a constant depth film fermenter (CDFF) for 96 h. Biofilms were treated with 2% and 5% NaOCl, alone or mixed with HEDP. Irrigants were applied under steady laminar flow for 8 min. Biofilm response was evaluated by means of optical coherence tomography (OCT). Biofilm removal, biofilm disruption, rate of biofilm loss and disruption as well as bubble formation were assessed. One-way ANOVA, Wilcoxon’s signed-rank test and Kruskal-Wallis H test were performed for statistical analysis of the data. The level of significance was set at a ≤ 0.05.

RESULTS: Increasing NaOCl concentration resulted in increased biofilm removal and disruption, higher rate of biofilm loss and disruption and increased bubble formation. Mixing HEDP with NaOCl caused a delay in the antibiofilm action of the latter, without compromising its antibiofilm efficacy.

CONCLUSIONS: NaOCl concentration dictates the biofilm response irrespective of the presence of HEDP. The addition of HEDP resulted in a delay in the antibiofilm action of NaOCl. This delay affects the efficiency, but not the efficacy of the irrigant over time.

PMID:35470434 | DOI:10.1111/iej.13754

Br J Clin Pharmacol. 2022 Apr 25. doi: 10.1111/bcp.15363. Online ahead of print.

ABSTRACT

AIM: To investigate the rates of hypersensitivity reactions (HSRs), in patients receiving paclitaxel chemotherapy, with and without a Histamine-2 (H₂ ) antagonists.

METHOD: This prospective, multi-centre, cohort study compared patients receiving paclitaxel treated with pre-medication regimens containing chlorphenamine, dexamethasone and an H₂ antagonist versus patients treated without an H₂ antagonist. Rates of HSRs were described and logistic multivariable regression was used to investigate any associations with H₂ antagonist treatment, adjusting for confounding variables.

RESULTS: 1043 were included in the study; of these, 638 (61%) patients received a H₂ antagonist and 405 (49%) were not given a H₂ antagonist. Incidence of HSR in the cohort treated with H₂ antagonists was 11.31% (n=70) versus 9.86% (n=41) in the cohort without. There was no statistically significant difference between the rates of HSR observed in those receiving and not receiving a H₂ antagonist (odds ratio 1.04, 95% CI 0.65, 1.66, P=0.9).

CONCLUSIONS: Results presented within the study are consistent with other recently published evidence to suggest that H2 antagonists do not confer any advantage as part of pre-medication regimens in reducing the incidence of HSR in patients treated with paclitaxel.

PMID:35470452 | DOI:10.1111/bcp.15363

Cardiol J. 2022 Apr 26. doi: 10.5603/CJ.a2022.0025. Online ahead of print.

ABSTRACT

BACKGROUND: Neoatherosclerosis after drug-eluting stent (DES) implantation is known to be related with increased risk of late restenosis and stent thrombosis. Neoatherosclerosis and relevant clinical outcomes between bioabsorbable polymer DES (BP-DES) and second-generation durable polymer DES (DP-DES) were evaluated by optical coherence tomography (OCT) analysis.

METHODS: A total of 311 patients (319 lesions) undergoing OCT analysis after DES implantation were enrolled and divided into two groups according to stent type (BP-DES [150 patients, 153 lesions] and DP-DES [161 patients, 166 lesions]). Follow-up OCT analysis was performed at least 9 months after index stent implantation. Neoatherosclerosis was defined as presence of thin-cap fibroatheroma, calcified plaque, and lipid plaque. Primary endpoint was the incidence of neoatherosclerosis, and the secondary endpoints were the occurrence of major adverse cardiac events (MACE), defined as a composite of death, myocardial infarction, target lesion revascularization, or stent thrombosis and to find independent predictors of neoatherosclerosis.

RESULTS: The incidence of neoatherosclerosis was lower in the BP-DES group than the DP-DES group (5.2% vs. 14.5%, p = 0.008), which was driven by lipid plaque. However, the incidence of MACE did not show statistical difference between the two groups in median 4-year follow-up (3.3% vs. 7.8%, hazard ratio 1.964, 95% confidence interval 0.688-5.611, p = 0.207). Less use of angiotensin converting enzyme inhibitors/angiotensin II receptor blockade and higher degree of neointimal hyperplasia remained independent predictors of neoatherosclerosis on Cox regression analysis.

CONCLUSIONS: Patients undergoing BP-DES implantation had lower incidence of neoatherosclerosis than DP-DES, which did not reach statistically better clinical outcomes.

PMID:35470415 | DOI:10.5603/CJ.a2022.0025

Eur Heart J Cardiovasc Imaging. 2022 Apr 26:jeac067. doi: 10.1093/ehjci/jeac067. Online ahead of print.

NO ABSTRACT

PMID:35470388 | DOI:10.1093/ehjci/jeac067

Minerva Gastroenterol (Torino). 2022 Apr 26. doi: 10.23736/S2724-5985.22.03189-8. Online ahead of print.

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causal agent of the coronavirus disease (COVID-19), has infected millions of people worldwide. Currently, the scientific community debates on the direct viral responsibility of liver damage or whether the observed changes are secondary manifestations of systemic inflammation triggered by COVID-19. The hepatic involvement is associated with worse clinical outcomes and higher risk of COVID-19 related morbidity and mortality. Furthermore, SARS-CoV-2 infection may predispose patients to thrombotic disease due to excessive inflammation, platelet activation, and endothelial dysfunction.

METHODS: In this paper, we reported a cross-sectional analysis of five patients affected by a severe form of COVID-19, who died between April 11 and May 1, 2020. Each patient has been subjected to a medico-legal autopsy in which both gross and histological liver changes were evaluated, as well as the correlation with the related coagulation profile.

RESULTS: In three cases of our cohort, the thromboembolism was recognized as cause of death. Furthermore, a significant statistical difference between D-dimer values at hospital admission and death among enrolled patients (p= 0.033), was evaluated. No patient has recorded a pre-existing liver disease.

CONCLUSIONS: Our results support the evidence that hepatic damage in subjects with severe form of COVID-19 is related to the changes in coagulative and fibrinolytic pathways. Hence, the evaluation of D-dimer blood levels may be useful in clinical practice to predict the involvement of the liver and the prognosis of these patients. This data highlights the fundamental role of coagulation balance in subjects with advanced form of COVID-19.

PMID:35470356 | DOI:10.23736/S2724-5985.22.03189-8

Am J Clin Nutr. 2022 Apr 25:nqac040. doi: 10.1093/ajcn/nqac040. Online ahead of print.

ABSTRACT

BACKGROUND: Recent preclinical research strongly suggests that dietary sugars can enhance colorectal tumorigenesis by direct action, particularly in the proximal colon that unabsorbed fructose reaches.

OBJECTIVES: We aimed to examine long-term consumption of sugar-sweetened beverages (SSBs) and total fructose in relation to incidence and mortality of colorectal cancer (CRC) by anatomic subsite.

METHODS: We followed 121,111 participants from 2 prospective US cohort studies, the Nurses’ Health Study (1984-2014) and Health Professionals Follow-Up Study (1986-2014), for incident CRC and related death. Cox proportional hazards regression was used to compute HRs and 95% CIs.

RESULTS: During follow-up, we documented 2733 incident cases of CRC with a known anatomic location, of whom 901 died from CRC. Positive associations of SSB and total fructose intakes with cancer incidence and mortality were observed in the proximal colon but not in the distal colon or rectum (Pheterogeneity ≤ 0.03). SSB consumption was associated with a statistically significant increase in the incidence of proximal colon cancer (HR per 1-serving/d increment: 1.18; 95% CI: 1.03, 1.34; Ptrend = 0.02) and a more pronounced elevation in the mortality of proximal colon cancer (HR: 1.39; 95% CI: 1.13, 1.72; Ptrend = 0.002). Similarly, total fructose intake was associated with increased incidence and mortality of proximal colon cancer (HRs per 25-g/d increment: 1.18; 95% CI: 1.03, 1.35; and 1.42; 95% CI: 1.12, 1.79, respectively). Moreover, SSB and total fructose intakes during the most recent 10 y, rather than those from a more distant period, were associated with increased incidence of proximal colon cancer.

CONCLUSIONS: SSB and total fructose consumption were associated with increased incidence and mortality of proximal colon cancer, particularly during later stages of tumorigenesis.

PMID:35470384 | DOI:10.1093/ajcn/nqac040

Ann Transplant. 2022 Apr 26;27:e935611. doi: 10.12659/AOT.935611.

ABSTRACT

BACKGROUND Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). MATERIAL AND METHODS From May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status. RESULTS During the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 (P=0.011, and P=0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P=0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale (P=0.059 and P=0.217, respectively). CONCLUSIONS Within 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.

PMID:35470353 | DOI:10.12659/AOT.935611

Sex Transm Dis. 2022 Apr 23. doi: 10.1097/OLQ.0000000000001637. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding spatial access to sexual health services will provide the foundation for future resource planning and allocation. The purpose of this study is to evaluate the potential geographic access to sexual health services in Toronto, Canada, by developing a novel accessibility index to sexual health clinics.

METHODS: We created an accessibility index using the two-step floating catchment area method to quantify neighbourhood level access to sexual health clinics. The index assumed mixed modes of urban travel through walking and public transit, as well as through driving, and was estimated at the census tract level.

RESULTS: Census tracts were grouped into quantiles by the estimated accessibility score. Census tracts with higher accessibility scores were characterized as those with greater residential instability and lower dependency and ethnic concentration. The downtown core area has all census tracts categorized as Medium, High, or Very High (average score = 1.320, sd = 0.312), whereas the non-core area has 56.98%, 302 out of 530 census tracts categorized as Medium, High, or Very High (average score = -0.105, sd = 0.960).

CONCLUSIONS: We demonstrated the benefit of using statistical methods to quantify the geographical access to sexual health services and identified neighbourhoods with high and low levels of access. Findings from this study present an overview of the level of spatial access to sexual health clinics in Toronto based on clinic locations in 2018 and can be further used to characterize neighbourhoods with lower level of access and inform policy and planning decisions in the city.

PMID:35470349 | DOI:10.1097/OLQ.0000000000001637