Τρίτη 23 Αυγούστου 2022

Serum vitamin D and cardiometabolic risk factors

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Abstract

Low serum 25-hydroxyvitamin D (25(OH)D) concentrations have been associated with greater adiposity and an adverse cardiometabolic risk profile, yet findings are inconsistent and the role of vitamin D status in cardiovascular disease (CVD) remains uncertain. We aimed to examine the associations between serum 25(OH)D and CVD risk factors in the British population. We analysed data on 2842 subjects aged ≥40 years enrolled in the National Diet and Nutrition Survey (NDNS 2008–2018). Based on serum 25(OH)D concentrations, study subjects were grouped in three categories: vitamin D deficiency (<25 nmol/L), vitamin D insufficiency (25-49 nmol/L) and vitamin D sufficiency status (≥50 nmol/mL). Differences in CVD risk factors between vitamin D deficiency or insufficiency and vitamin D sufficiency status were expressed in standard deviation scores (SDSs) and estimated through weighted multiple linear regression models. We found that vitamin D deficiency was directly associated with B MI, waist circumference, triglycerides and inversely associated with high-density lipoprotein cholesterol (HDL) values. The strongest associations were found between vitamin D deficiency and triglycerides (0.50 SDS, 95% CI: 0.24, 0.77) among men, and vitamin D deficiency and waist circumference (0.70 SDS, 95% CI: 0.56, 0.94), BMI (0.63 SDS, 95% CI: 0.39, 0.88) and triglycerides (0.54 SDS, 95% CI: 0.30, 0.77) among women. When adjusting for BMI the association with triglyceride attenuated (from 0.50 SDS to 0.39 SDS among men and from 0.54 SDS to 0.30 SDS among women). Our data indicates a relationship between inadequate vitamin D status and an adverse CVD risk profile. However, interventional studies are needed to establish possible benefits of vitamin D supplementation on cardiovascular risk.

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The Duration and Magnitude of Postdischarge Venous Thromboembolism Following Colectomy

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imageObjective: To assess the impact of current guidelines by reporting weekly postoperative postdischarge venous thromboembolism (VTE) rates. Summary Background Data: Disparity exists between the postoperative thromboprophylaxis duration colectomy patients receive based on surgical indication, where malignant resections routinely receive 28 days extended thromboprophylaxis into the postdischarge period and benign resections do not. Methods: English national cohort study of colectomy patients between 2010 and 2019 using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data. Stratified by admission type and surgical indication, absolute incidence rates (IRs) per 1000 person-years and adjusted incidence rate ratios (aIRRs) for postdischarge VTE were calculated for the first 4 weeks following resection and postdischarge VTE IRs for each postoperative week to 12 weeks postoperative. Results: Of 104,744 patients, 663 (0.63%) developed postdischarge VTE within 12 weeks after colectomy. Postdischarge VTE IRs per 1000 person-years for the first 4 weeks postoperative were low following elective resections [benign: 20.66, 95% confidence interval (CI): 13.73–31.08; malignant: 28.95, 95% CI: 23.09–36.31] and higher following emergency resections (benign: 47.31, 95% CI: 34.43–65.02; malignant: 107.18, 95% CI: 78.62–146.12). Compared with elective malignant resections, there was no difference in postdischarge VTE risk within 4 weeks following elective benign colectomy (aIRR=0.92, 95% CI: 0.56–1.50). However, postdischarge VTE risks within 4 weeks following emergency resections were significantly greater for benign (aIRR=1.89, 95% CI: 1.22–2.94) and malignant (aIRR=3.13, 95% CI: 2.06–4.76) indications compared with elective malignant colectomy. Conclusions: Postdischarge VTE risk within 4 weeks of colectomy is ∼2-fold greater following emergency benign compared with elective malignant resections, suggesting emergency benign colectomy patients may benefit from extended VTE prophylaxis.
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Δευτέρα 22 Αυγούστου 2022

Integrated analysis of probability of type 2 diabetes mellitus with polymorphisms and methylation of SLC30A8 gene: a nested case-control study

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Docetaxel Targets Aggressive Methylation Profiles and Serves as a Radiosensitizer in High-Risk Meningiomas

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Abstract
Background
Meningioma is the most common primary intracranial tumor in adults. A subset of these tumors recur and invade the brain, even after surgery and radiation, resulting in significant disability. There is currently no standard-of-care chemotherapy for meningiomas. As genomic DNA methylation profiling can prognostically stratify these lesions, we sought to determine whether any existing chemotherapies might be effective against meningiomas with high-risk methylation profiles.
Methods
A previously published dataset of meningioma methylation profiles was used to screen for clinically significant CpG methylation events and associated cellular pathways. Based on these results, patient-derived meningioma cell lines were used to test candidate drugs in vitro and in vivo, including efficacy in conjunction with radiotherapy.
Results
We identi fied 981 genes for which methylation of mapped CpG sites was related to progression-free survival in meningiomas. Associated molecular pathways were cross-referenced with FDA-approved cancer drugs, which nominated Docetaxel as a promising candidate for further preclinical analyses. Docetaxel arrested growth in 17 meningioma cell sources, representing all tumor grades, with a clinically-favorable IC50 values ranging from 0.3 nM to 10.7 mM. The inhibitory effects of this medication scaled with tumor doubling time, with maximal benefit in fast-growing lesions. The combination of Docetaxel and radiation therapy increased markers of apoptosis and double-stranded DNA breaks, and extended the survival of mice engrafted with meningioma cells relative to either modality alone.
Conclusions
Global patterns of DNA methylation may be informative for the selection of chemotherapies against meningiomas, and existing drugs may enhance radiation sensitivity in high-risk cases.
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Effects of maxillomandibular advancement on respiratory function and facial aesthetics in obstructive sleep apnoea patients with versus without maxillomandibular deficiency

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The aim of this study was to compare the effects of maxillomandibular advancement (MMA) on respiratory function between obstructive sleep apnoea (OSA) patients with and without maxillomandibular deficiency, and to compare the changes in facial aesthetics after MMA between the two groups. MMA-treated patients who had both baseline and follow-up polysomnography (PSG) data and lateral cephalograms were enrolled in this retrospective study. In addition to PSG and cephalometric data, patient satisfaction with postoperative breathing and facial aesthetics, and overall satisfaction with the treatment were assessed. (Source: International Journal of Oral and Maxillofacial Surgery)
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Κυριακή 21 Αυγούστου 2022

Declining prevalence of HIV-associated neurocognitive disorders in more recent years and associated factors, in a large cohort of ART-treated HIV-infected individuals

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Abstract
Background
Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-living-with-HIV (PLWH).
Methods
ART-treated PLWH, underwent a neuropsychological examination through a battery of 12 tests exploring 5 different domains, between 2009-2020, were included in this cross-sectional analysis. HAND were classified according to Frascati's criteria. Participants were defined as complaining or not-complaining if a cognitive complaint was reported or not. Chi-square for trend and multivariable logistic regression were fitted.
Results
Overall, 1,424 PLWH were enrolled during four three-years periods. HAND prevalence was 24%. Among complainers (572/1,424), HAND prevalence was 38%, higher than among not-complainers (15%). Over the study period, a decreasing HAND prevalence was found in the entire population (p < 0.001) and in complaining (p < 0.001); in not-complaining it remained stable (p = 0.182). Factors associated with HAND were older age, lower educational level, lower current CD4+ T-cell count and HCV co-infection. Compared to Non-Nucleoside Reverse Transcriptase Inhibitors, individuals receiving dual and Integrase Strand Transfer Inhibitor (INSTI)-based therapies were associated with a decreased risk of HAND, as well as participants tested in more recent years.
Conclusions
In this large cohort of ART-treated PLWH, mostly virologically suppressed, a remarkable decreasing HAND prevalence was observed . Besides HIV- and patient-related factors, the reduced risk of HAND found with dual and INSTI-based regimens along with a more recent ART initiation, could suggest a potential role of new treatment strategies in this decline, due to their greater virologic efficacy and better tolerability.
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Transmucosal pterygomaxillary disjunction using a piezoelectric device, in the context of the minimally invasive Le Fort I osteotomy protocol

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The aim of this study was to assess the accuracy and clinical implications of pterygomaxillary junction (PMJ) disjunction with a transmucosal PMJ osteotomy using a piezoelectric hand-piece device, in the context of Le Fort I osteotomy, by evaluating the level of PMJ disarticulation and the need for bone trimming around the pedicle. An ambidirectional 1-month follow-up cohort study was designed involving consecutive patients undergoing minimally invasive maxillary Le Fort I osteotomy through the twist technique. (Source: International Journal of Oral and Maxillofacial Surgery)
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