Biomedicine (Journal)
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Differential item functioning analysis on the Geriatric Depression Scale-15: an iterative hybrid ordinal logistic regression
No full textThe elderly population has extensively increased globally, so depression like a common problem in late life may convert to one of the economic, social, and health challenges of the 21st century. Due to the high cost of clinical diagnosis of depression, it is necessary to provide effective questionnaires like the 15-item Geriatric Depression Scale (GDS-15) for screening. But, the measurement invariance of GDS-15 is still unknown in the general population. In our study, 1473 participants of all Iranʼs ethnic groups were asked to answer GDS-15 and demographic factors such as human settlements, employment, disease, marital status, age, gender, homebound, financial status, and ethnicity. Then, the lordif package in R 3.1.3 was used to assess differential item functioning (DIF) items that behave unevenly across demographic factors. Our findings reveal that women, homebound patients, poorer, and non-Persian mother tongue score classic psychological symptoms higher than peoples of the same depression score in other groups. Since, psychologists have to remove or replace these items before using this questionnaire for screening geriatric depression
Predictors Of Mortality In Hospitalized COVID-19 Patients: A Mexican Population-Based Cohort Study.
No full textObjectives. COVID-19 outbreak brings a challenge to healthcare systems. The sex, age, and cardiometabolic comorbidities have been considered risk factors for disease severity. To evaluate the association between risk factors with death as well the risk of death in hospitalized COVID-19 patients.
Methods. The present cross-sectional cohort study, includes hospitalized SARS‑CoV‑2 confirmed cases. Data analysis was performed using the National COVID‑19 Cases Report Database. Pearson´s χ2 test and odds ratios (95% CI) were calculated to determine the association between variables. Thereafter, risk of death was evaluated by Cox proportional hazards model.
Results. A total of 67 328 inpatients were included; mean age 55.29 years (±15.97). Of total, 42 164 (62.62%) were men, 6 349 (9.43%) were intubated, and 23 873 (35.46%) died. Male sex, age older than 60 years, and cardiometabolic comorbidities were associated with death. Hazard ratio for death in older intubated patients was lower than in non-intubated (HR 1.242, 95%CI, 1.167–1.322; PP
Conclusions. Tracheal intubation or not is the most important predictor for death in COVID-19 infected patients in this Mexican cohort. Already known risk factors for COVID-19 severity may become less relevant once patients require tracheal intubation
Anterior cervical spine surgery opens up concerns about thyroid function
No full textBackground and objectives: The anterior approach for cervical discectomy and fixation is a valuable procedure for decompression of the spinal cord in patients with severe canal stenosis and stabilization of cervical vertebral column. Although some studies have investigated the thyroid complications especially in cervical cancer surgery or recently in tracheostomy, little research has been performed on the anterior spine surgery so far. The present study aimed to evaluate possible changes in the thyroid in patients experiencing anterior cervical approaches for degenerative diseases.
Materials and Methods: Seventy patients who were undergoing anterior cervical spine surgery were selected and their demographic information was recorded, including age, sex, weight, body mass index (BMI), and medical records. Thyroid hormones (TSH, free T4, and free T3) were measured before surgery and three months after surgery.
Results: Most patients had cervical disc herniation (60%). The mean duration of surgery was 71.9 ± 8.36 minutes (range: 60- 90 minutes). Twenty-one patients (30%) had anterior plating while 49 patients (70%) did not. Spearman’s correlation coefficient was used to examine the correlation of the following variables with TSH changes: Number of operated cervical levels, level of operated spine, incision type, duration of surgery, type of surgery (ACDF or ACCF). None of these variables showed a significant correlation. Meanwhile, a significant and direct correlation was observed between TSH changes and age.
Conclusions: Although the results of our study did not show any signs of functional changes due to thyroid tissue injury during surgery, based on rare case reports and age-related laboratory changes, we recommend thyroid function tests for diagnosing subclinical thyroid dysfunction before anterior cervical spine surgery in patients with degenerative diseases and especially in older adults
Bioactivities and action mechanisms of active compounds from Hottuynia cordata THUNB on human lung cancer cells
No full textBackground: Lung cancer is the leading cause of death in Taiwan for years. Besides the currently used chemotherapy, herbal medicine may play a role in the treatment of lung cancer. Hottuynia cordata Thunb (HC), one of the frequently used herbal medicine in Taiwan, has been widely used in various diseases. Review from literatures, HC has many effects, including anti-inflammatory, anti-viral, anti-bacterial, anti-SARS, and anti-tumor activities. However, there is no literatures describe its active compounds on lung cancer. This present study aims to evaluate the possible effect and action mechanism of active compounds from HC (aristolactam BII, aristolactam AII, and noraristolodione) on lung cancer. A549 lung cancer cell line was used to evaluate the effects of HC on the cell viability and possible anti-tumor effects.
Methods: We used A549 cells in the evolution of anticancer activity. Cell viability, cell cycle, cell apoptosis and apoptosis related protein expression were studied.
Results: Active compounds from HC significantly inhibit A549 cell viability and induce accumulation of cell cycle at S or G2/M phase on A549 cells in a dose-dependent manner, and induce A549 arrest at S or G2/M phase via increasing p21, p27, p53 and reducing cyclin-E, -A, cyclin-dependent kinase 2 (CDK2), cdc-2 (CDK1) protein expression. Additionally, HC induce A549 cell late apoptosis by up-regulating caspase-3, -8, Bax and decreasing Bcl-2 protein expression.
Conclusions: The anti-tumor effects of aristolactam BII, aristolactam AII, and noraristolodione on human lung carcinoma A549 cells are via cell cycle arrest and apoptosis
The Association of rs187238, rs19465518 and rs1946519 IL-8 Polymorphisms with Acute Kidney Injury in Preterm Infants
No full textABSTRACT
Background: Interleukin 18 (IL-18) promoter polymorphisms (-656G\u3eT, -607C\u3eA, and -137G\u3eC) affect serum IL-18 (sIL-18) levels and are associated with renal injury.
Purpose: This study aimed to determine the diagnostic utility of sIL-18 and urine IL-18 (uIL-18) as biomarkers for acute kidney injury (AKI) and analyse the association of IL-18 polymorphisms to AKI in preterm infants.
Methods: Blood and urine samples were collected from 56 preterm infants with AKI and 56 without AKI to measure serum creatinine (SCr), sIL-18, and uIL-18. Genotyping of polymorphisms was performed and analysed, with AUC-ROCs analysis used to evaluate the diagnostic utility of s-/uIL-18 levels.
Results: The median sIL-18 and uIL-18 levels were significantly higher than those without AKI. For a cutoff of \u3e132 pg/mL, the sIL-18 expression had sensitivity and specificity of 80.36% and 60.71%, respectively, while for uIL-18, a cutoff of \u3e900.7 pg/mL had sensitivity and specificity of 51.79% and 78.57%, respectively. The odds ratio of sIL-18 and uIL-18 to predict AKI in preterm infants was 5.89 (95%CI:2.31–15.02) and 4.15 (95%CI:1.58–10.89), respectively. The polymorphisms -137G\u3eC and -656G\u3eT were significantly associated with sIL-18 expression.
Conclusion: Serum and urine IL-18 levels are risk factors for and a moderate predictor of AKI in preterm infants
Contralateral recurrent laryngeal nerve palsy in revision anterior cervical discectomy and fusion (ACDF): A cautionary tale
No full textRevision anterior cervical spine surgery has a higher risk of recurrent laryngeal nerve palsy (RLNP). We describe a unique case of an isolated RLNP contralateral to the side of the surgical approach in a patient who underwent revision anterior cervical discectomy and fusion (ACDF) for cervical myelopathy, and in whom pre-operative laryngoscopic evaluation had excluded a pre-existing occult RLNP. Scarring around the recurrent laryngeal nerve at the previous surgical site may have rendered it less mobile, resulting in it being more susceptible to compression from an inflated endotracheal tube (ETT) cuff or traction from surgical retractors. This case illustrates that acute RLNP can rarely occur contralateral to the side of surgical approach in the setting of revision surgery. Surgeons performing revision ACDF can consider approaching from the same side as the index surgery or a posterior approach to reduce the risk of developing bilateral RLNP
Nosocomial COVID-19 infection in patients with nasal trauma during coronavirus pandemic
No full textObjectives: Considering the reduction of patients\u27 attendance in hospitals, including patients with nose fracture, in fear of COVID-19 transmission, this study aims to investigate the risk of nosocomial COVID-19 transmission in patients with nasal trauma seeking medical care in hospital.
Methods: Patients with nasal trauma referred to our specialized ENT referral center were evaluated, treated, and followed, up to two weeks. After discharge, COVID-19 symptoms were questioned by telephone, and additional assessments were requested for suspected patients.
Results: Out of 108 patients with possible nasal fracture, 27 didn’t need nasal reduction after physical examination while 81 required nasal bone reduction. Only one of the patients contracted the virus in the 2-week follow-up period, and the difference between the two groups was not statistically significant.
Conclusion: Patients in need of emergency medical services -like nasal trauma- in outpatient and short-term inpatient settings should not avoid going to the hospitals. This is provided when both medical staff and patients follow the health protocols
The level of transforming growth factor beta as a possible predictor of cyclophosphamide response in children with steroid-resistant nephrotic syndrome
No full textBackground:Steroid-resistant nephrotic syndrome (SRNS) is a burden in the country due to the progressive severity of chronic kidney disease (CKD). Calcineurin inhibitors (CNIs) or monoclonal antibodies are currently recommended for the treatment of this disease. In developing countries, steroid and cyclophosphamide (CPA) are available drugs used during the treatment. This study aims to provide a non-invasive modality that can be used to predict the response of SRNS children to CPA therapy. Subsequently, the proteinuria duration was shortened to reduce the risk of glomerular damage.
Method:A prospective-cohort-study was conducted at Hasan Sadikin General Hospital Bandung, Indonesia. A total of 88 SRNS children, aged 1 to 18 were accessed for serum TGF-ß level before receiving CPA therapy for six months, and clinical signs were observed. Furthermore, after six months of CPA treatment, the subjects were divided into CPA responder and non-responder based on the present of proteinuria, then the data were analyzed using multiple logistic regression to adjust age and gender.
Results:There was a statistically significant relationship between TGF-β and the risk of non-response to CPA therapy, after accounting for age, gender, baseline GFR, baseline ureum, and baseline urinary protein, the adjusted-OR was 1.051 (95% CI 1.007, 1.097, p = 0.022).
Conclusion:The high level of serum TGF-β obtained prior to CPA administration are reliable data for estimating adverse results on CPA therapy. Based on these results, a high baseline TGF-β level correlates with the poor response of CPA therapy.
Keywords:
Albumin-creatinin ratio, correlation, cyclophosphamide, steroid-resistant nephrotic syndrome, TGF-
Combined Posterior and Anterior Approaches for Cervical Intradural Disc Herniation: A Case Report
No full textIntradural disc herniation (IDH) is an extremely rare condition. The authors report the case of a 53-year-old female who had neck and right shoulder pain associated with right-sided hemiparesis and hyperesthesia. Magnetic resonance imaging (MRI) of the cervical spine (C-spine) revealed central mass-like lesions that caused the compression of the right side of the spinal cord. The posterior surgical approach was used to remove two pieces of IDH. After surgery, the muscle strength in the right upper limb improved from Grade 0/5 to 4+/5 without surgery-related complications. Although there are some reports in literature on the radiologic features of cervical IDH (including the Halo sign, Y-sign, hawk-beak sign, and crumble disc sign), it can be difficult to diagnose radiologically. We present the clinical image of the case along with a review of the literature to remind surgeons to consider IDH as a differential diagnosis when patients are affected by anterior intradural lesions
Median and Ulnar Nerve Injuries in Cyclists: A Narrative Review
No full textCycling is popular internationally as a mode of transport and sport. Cyclists often report sensory and motor changes in the hands during rides. In the past, assessment of these symptoms was based on clinical history, physical examination and neurophysiology. The aim of this narrative review was to evaluate existing publications and determine if there are areas for further improvement in the clinical setting. Methods: Searches were undertaken in accordance with the PRISMA guidelines using four online databases: PUBMED, OVID, CINAHL and WEB OF SCIENCE. Articles were evaluated using adapted versions of guidelines for case and cohort studies. Results: 2630 articles were found and 13 were included in the review. 2 considered median, 9 considered ulnar and 2 assessed both nerves. 11 were case and 2 were cohort studies. 7 discussed neurophysiology and 1 mentioned ultrasound as a modality of investigation. Interventions were described in 3 articles. Conclusion: The quality of evidence is generally low when considering this problem. Clinical assessment and neurophysiology are commonly regarded as the method for assessing nerve symptoms amongst cyclists. Advances in musculoskeletal ultrasound add to our early investigative repertoire and may help expedite management and limit future disability. In addition, further research is required into screening and preventative measures amongst cyclists.
2630 articles were found and 13 were included in the review. 2 considered median, 9 considered ulnar and 2 assessed both nerves. 11 were case and 2 were cohort studies. 7 discussed neurophysiology and 1 mentioned ultrasound as a modality of investigation. Interventions were described in 3 articles. Conclusion: Clinical assessment and neurophysiology are commonly reported as the method for assessing nerve symptoms amongst cyclists. Advances in musculoskeletal ultrasound mean we should consider this as part of the investigative repertoire. In addition, further research is required into screening and early interventions to limit the onset of more disabling symptoms