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Nevin Manimala Statistics

Cardiovascular status of breast cancer patients before and after receiving anthracycline chemotherapy regimen

Nurs Open. 2021 Sep 30. doi: 10.1002/nop2.1059. Online ahead of print.

ABSTRACT

AIM: To explore the effect of TEC chemotherapy regimen (Docetaxel + Epirubicin + Cyclophosphamide) on traditional cardiovascular risk factors, atherosclerotic cardiovascular disease and cardiac electrical activity.

DESIGN: 243 patients with first initially diagnosed breast cancer were collected who receiving TEC chemotherapy.

METHODS: Univariate analysis, multivariate analysis, binary logistic regression analysis and statistical description were used to analyse the data.

RESULTS: Among the first diagnosed patients, prevalence of hypertension and overweight/obesity in postmenopausal patients were significantly higher than premenopausal group. Compared with initially diagnosed state, incidence of hyperlipidaemia increased significantly after TEC chemotherapy, blood glucose level was remarkably increased, and prevalence of hyperuricaemia was significantly increased, changes of blood pressure level and prevalence rate of hypertension were not significant, and there was no statistical difference. Different menopause status showed the same trend. Atherosclerotic cardiovascular disease risk stratification showed after chemotherapy low-risk patients decrease, medium-risk and high-risk people increased. Grouped by menstrual status, after chemotherapy, both groups showed the same trend. The independent influencing factors of increased heart rate after chemotherapy were postmenopausal status. Postmenopausal patients had more cardiovascular risk factors than premenopausal patients. After receiving chemotherapy, levels of cardiovascular risk factors in both groups mostly changed to the direction of disease. Chemotherapy drugs increase the risk of atherosclerotic cardiovascular disease in breast cancer patients. It is necessary to strengthen interdisciplinary cooperation to dynamic assess the cardiovascular health of patients of breast cancer patients.

PMID:34592784 | DOI:10.1002/nop2.1059

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Is fetal nuchal cord associated with autism spectrum disorder? A meta-analysis

Clin Exp Pediatr. 2021 Sep 24. doi: 10.3345/cep.2021.00514. Online ahead of print.

ABSTRACT

PURPOSE: There is inconsistent evidence about the association between fetal nuchal cord and the risk of autism spectrum disorder (ASD). We performed a meta-analysis to investigate whether fetal nuchal cord is associated with an increased risk of ASD in offspring.

METHODS: Three main English databases were searched until January 2021. The Newcastle-Ottawa Scale was used to assess study quality. Study heterogeneity was determined using the I2 statistic, while publication bias was assessed using Begg’s and Egger’s tests. Results are presented as odds ratios (ORs) and relative ratios with 95% confidence intervals (CI) and were determined by a random-effects model.

RESULTS: Five articles (one cohort, four case-control; 3088 total children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (OR=1.11; 95% CI, 0.66-1.57). There was homogeneity among studies that reported a risk of ASD (I2=0.0%).

CONCLUSION: Our results showed that fetal nuchal cord is not a risk factor for ASD. Future large cohort studies should confirm this finding.

PMID:34592803 | DOI:10.3345/cep.2021.00514

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Clinical and Molecular Study of the NOG Gene in Families with Mandibular Micrognathism

Eur J Dent. 2021 Sep 30. doi: 10.1055/s-0041-1726162. Online ahead of print.

ABSTRACT

OBJECTIVES: Previous studies showed that noggin gene (NOG) sequence alterations, as well as epigenetic factors, could influence mandibular development. The aim of this study was to analyze clinical characteristics, NOG gene sequences, and promoter methylation sites in patients with mandibular micrognathism.

MATERIALS AND METHODS: A total of 35 individuals of five Colombian families were subject to clinical and cephalometric analysis for mandibular micrognathism. One nonaffected individual of each family was included as a control. DNA was isolated from whole blood sample from all individuals by salting out method. Nine NOG gene fragments were amplified by polymerase chain reaction (PCR) and sequenced. Identification of CpG islands for methylation analysis at the NOG gene promoter was performed by MSP-PCR kit (Qiagen R).

STATISTICAL ANALYSIS: A descriptive statistical analysis was carried out evaluating the presence or absence of genetics variants and the methylation sites in the NOG gene.

RESULTS: NOG sequence results of affected individuals with mandibular micrognathism for one of the families studied demonstrated that they were heterozygous for 672 C/A (new mutation). For a second family, individuals were heterozygous for 567 G/C (single nucleotide polymorphism [SNP] RS116716909). For DNA analyzed from all patients studied, no methylations were observed at the NOG gene promoter region.

CONCLUSION: Our results suggest that 672 C/A and 567 G/C variants could be involved in the presence of mandibular micrognathism. Moreover, lack of methylation sites at the NOG gene promoter region of all individuals studied suggests possibly other epigenetic factors could modulate mandibular growth. The search of genetic variants related with mandibular micrognathism will allow to predict in an integral way the development patterns of the patients and therefore establish a better clinical treatment.

PMID:34592770 | DOI:10.1055/s-0041-1726162

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Acquired autoimmune Haemophilia following SARS-CoV-2 vaccines: Dual drug effects on blood coagulation and the Scylla and Charybdis phenomenon

Thromb Haemost. 2021 Sep 30. doi: 10.1055/a-1658-4852. Online ahead of print.

ABSTRACT

Vaccination against the SARS-CoV-2 may lead to immunologic reactions activating the haemostatic system and resulting in both venous and arterial thromboembolism. Aquired autoimmune Haemophilia following SARS-CoV-2 vaccines were now reported 15 to 19 days (or later) after vaccination and resolution of symptoms by adequate treatment of the immunologic reaction. From patients’ point of view, anticoagulants and SARS-CoV-2 vaccines share their capacity to induce thrombosis as well as bleeding and clinicians are subjected to Scylla and Charybdis when they treat patients not only with anticoagulants but also with SARS-CoV-2 vaccines. Careful analysis of coincidence and causality requires attention when reporting on acquired coagulation inhibitors regarding severity, treatments, duration and statistical risk.

PMID:34592779 | DOI:10.1055/a-1658-4852

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Concomitant opioid and benzodiazepine use and risk of suicide attempt and intentional self-harm: Pharmacoepidemiologic study

Drug Alcohol Depend. 2021 Sep 20;228:109046. doi: 10.1016/j.drugalcdep.2021.109046. Online ahead of print.

ABSTRACT

BACKGROUND: Overdose due to concomitant use of opioids and benzodiazepines has been raised as a major public health concern, although little research has examined whether this risk extends to intentional overdose or other self-harm. This study examined whether prescription opioids and benzodiazepines interact to increase the rate of suicide attempt and intentional self-harm.

METHODS: The study analyzed 4762,438 users of opioids, benzodiazepines, both drugs concomitantly, or neither drug from the MarketScan Commercial Claims and Encounters databases (2014-2016). The four groups were matched using inverse probability of treatment weighting and a difference in difference design was used to examine associations with risk of suicide attempt, intentional self-harm and drug overdose, including suicide death resulting in a medical claim.

RESULTS: There was a small association for opioids (HR=1.23; 95% CI 1.06-1.43) but a larger association for benzodiazepines (HR=2.55; 95% CI 2.12-3.05) with suicide attempt, intentional self-harm, and drug overdose. The medication interaction was opposite to the expected direction (HR=0.70; 95% CI 0.55-0.89), indicating that risk associated with concomitant use was lower than would be expected on an additive basis. Sensitivity analyses found no evidence of increased risk due to interaction between the two drug classes.

CONCLUSIONS: Increased risk of suicide attempt, intentional self-harm and drug overdose for concomitant use of opioids and benzodiazepines is in large part attributable to benzodiazepine use alone. In typically prescribed quantities, opioids and benzodiazepines may not represent a drug interaction in terms of yielding increased risk of suicide attempt and intentional self-harm resulting in medical care.

PMID:34592702 | DOI:10.1016/j.drugalcdep.2021.109046

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Can intubation be improved with endotracheal tubes marked with a color scale? Randomized controlled study

Am J Perinatol. 2021 Sep 30. doi: 10.1055/a-1659-0422. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess if a color scale in the endotracheal tube (ETT) helps operators to correctly select the size and depth of placement of the ETT and decrease the time required, compared with the usual numeric ETT scale, in a mannequin model.

DESIGN/METHODS: The study was conducted in 8 centers. Each size of the ETT was identified with different color by size. All experimental ETT had two painted zones: the mouthpiece and an area of 1 cm marked with the same color (to identify where the ETT should be taped above the lip). The operators were trained as part of the protocol using a video. Four clinical scenarios requiring endotracheal intubation were designed and randomly assigned. Each operator had to select the size and depth of ETT based on the BW, and then had to perform 4 intubation procedures.

RESULTS: 108 operators performed 432 intubations. No difference were found in the correct placement and selection of the ETT. Median time (in seconds) required for intubation using numeric vs. experimental tube was: for ETT Ø 2.5, 11.5 vs. 8 (p<0.001), ETTØ3,12 vs. 10 (p<0.001), ETT Ø 3.5, 15.5 vs.12 (p 0.003), ETT Ø4 12 vs.11 (p 0.019).

CONCLUSIONS: No significant difference was observed in the selection and correct placement of the ETT. However, the intubation time was significantly shorter using the experimental ETT. This device could improve the effectiveness of intubation by reducing the time needed to properly place the ETT at mid trachea.

PMID:34592768 | DOI:10.1055/a-1659-0422

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Weight average approaches for predicting dynamical properties of biomolecules

Curr Opin Struct Biol. 2021 Sep 27;72:88-94. doi: 10.1016/j.sbi.2021.08.008. Online ahead of print.

ABSTRACT

Recent advances in atomistic molecular dynamics (MD) simulations of biomolecules allow us to explore their conformational spaces widely, observing large-scale conformational fluctuations or transitions between distinct structures. To reproduce or refine experimental data using MD simulations, structure ensembles, which are characterized by multiple structures and their statistical weights on the rugged free-energy landscapes, are often used. Here, we summarize weight average approaches for various experimental measurements. Weight average approaches are now applied to hybrid quantum mechanics/molecular mechanics MD simulations to predict fast vibrational motions in a protein with a high accuracy for better understanding of molecular functions from atomic structures.

PMID:34592697 | DOI:10.1016/j.sbi.2021.08.008

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BuCyE can safely replace BEAM as a conditioning regimen for autologous stem cell transplantation in the treatment of refractory and relapsed lymphomas

Leuk Res. 2021 Sep 15;110:106689. doi: 10.1016/j.leukres.2021.106689. Online ahead of print.

ABSTRACT

INTRODUCTION: Hodgkin’s (HL) and non-Hodgkin’s (NHL) lymphomas have usually high cure rates. The standard of care for chemosensitive relapsed/refractory lymphoma patients is salvage chemotherapy followed by AHSCT. Due to carmustine and melphalan shortages, alternative pre-AHSCT conditioning regimens with similar tolerance and response were needed.

OBJECTIVES: To compare the efficacy and toxicity profile between relapsed/refractory HL and NHL lymphomas given BEAM or BuCyE.

METHODS: A retrospective analyses of 122 patients in a Brazilian center was made. OS and PFS were calculated by Kaplan-Meier and compared by log rank. Toxicity and engraftment data were also compared.

RESULTS: Most clinical characteristics were similar between groups, although a higher frequency of grade ≥ 2 mucositis (p = .01) was seen in the BuCyE group. No significant difference in OS or PFS were observed between the groups.

CONCLUSION: BEAM and BuCyE are well tolerated with similar toxicity profiles and survival outcomes. Therefore, BuCyE conditioning regimen can be considered an alternative to BEAM.

PMID:34592699 | DOI:10.1016/j.leukres.2021.106689

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Preliminary report of patients with meningiomas exposed to Cyproterone Acetate, Nomegestrol Acetate and Chlormadinone Acetate – Monocentric ongoing study on progestin related meningiomas

Clin Neurol Neurosurg. 2021 Sep 23;210:106959. doi: 10.1016/j.clineuro.2021.106959. Online ahead of print.

ABSTRACT

INTRODUCTION: The relationship between meningioma and progestins has not been elucidated. Meningioma regression after acetate cyproterone (CA) withdrawal has been reported. Our purpose was to evaluate the meningioma evolution after withdrawal of progestins in patients who underwent long-term exposure to CA, nomegestrol acetate (NA), chlormadinone acetate (ChlA).

METHODS: Our study retrospectively included 69 patients with intracranial meningioma and exposed to one of these 3 progestins between December 2006 and March 2019. In each patient, clinico-radiological (MRI) follow-up was performed every 6 months after diagnosis and treatment withdrawal recommendation. Statistical analyses were applied to compare tumor location and respect of prescription rules between the 3 groups.

RESULTS: The mean hormonal exposure was 16 years in CA group (n = 46), 16 years in NA group (n = 12) and 9.7 years in ChlA group (n = 11). A higher rate of “out of label” use was observed in the CA group (p = 0.003). Multiple meningiomas were demonstrated in more than 60% of cases in each group. Anterior skull base location was noted in 60.5% of cases in CA group, 25% of cases in NA group and 36.7% of cases in ChlA group (p = 0.05). Incomplete tumor regression was recorded in 11 cases of CA group and in 2 cases of ChlA group.

CONCLUSION: In CA group, our results suggest a strong relationship between this treatment and development of intracranial meningioma. In presence of voluminous asymptomatic meningioma, treatment can be delayed due to the potential regression after withdrawal. On the contrary in NA and ChlA groups, further studies are needed.

PMID:34592677 | DOI:10.1016/j.clineuro.2021.106959

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Cultural and technology elucidation of the Tupi-Guarani tradition through analysis of potsherds from Travessão do Rio Vermelho site (Santa Catarina – Brazil) by spectroscopy, SEM-EDS and chemometrics

Appl Radiat Isot. 2021 Sep 21;178:109957. doi: 10.1016/j.apradiso.2021.109957. Online ahead of print.

ABSTRACT

Ceramic fragments can provide an insight into the ancient culture and practices of groups of humans and their way of life (technology, cultural identity, social organization, habitation and economy). Scientific analysis can be used to obtain information on the ceramic production process, as well as the specificities of the material employed. In this research, all samples of archaeological potsherd from the Tupi-Guarani tradition were analyzed in order to identify and to characterize the structures, morphologies and the elemental composition by using by scanning electron microscopy (SEM-EDS) and multivariate statistical methods (PCA and HCA). FTIR spectroscopy revealed the presence of an organic residue in three samples along with carbonates, clay minerals, quartz and hematite. In addition, the presence of the stretching attributed to water molecules in crystalline systems was observed. Also, the presence of TiO2 in the anatase polymorphic form was detected using μ-Raman spectroscopy. These results indicate a firing temperature of between 800 and 1000 °C. In relation to the morphology, all samples revealed amorphous structures presenting isolated and heterogenic particles of different forms and sizes, and the EDS spectrum confirmed the elements present in the molecular structures elucidated by vibrational spectroscopy. The multivariate analysis has confirmed the correlation between the elemental compositions of ceramics collected from two different sites: a mountain region and a coastal area in Santa Catarina State, Brazil.

PMID:34592693 | DOI:10.1016/j.apradiso.2021.109957