Matched-pair Case-control Study Research Articles

High levels of soluble P-selectin, neutrophil extracellular traps, and myeloperoxidase as risk factor of deep vein thrombosis in malignancy patients receiving platinum-based chemotherapy

Backgrounds Venous Thromboembolism (VTE) is a disease entity comprising Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). VTE events increase the mortality rate of patients with cancer receiving platinum-based chemotherapy. Soluble P-Selectin, Neutrophil Extracellular Traps (NET), and myeloperoxidase (MPO) are risk factors associated with DVT in malignancy patients receiving platinum-based chemotherapy. The purpose of this study was to determine the role of soluble P-selectin, NET, and MPO as risk factors for DVT in patients with malignancy receiving platinum-based chemotherapy. Patients and Methods This study used a case-control design (matched pair case-control study) based on age and gender. The case group consisted of subjects with DVT, whereas the control group consisted of subjects without DVT. The subjects were 31 in each case and control groups. Soluble P-selectin, NET, and MPO levels were measured in each group. Results The mean age of case group was 50.26±12.15 years meanwhile in control group was 52.81±11.64 years. In the case group, 71% of the subjects were female, whereas 51.6% of the control group were male. Most subjects, either in the case group (71%) or the control group (71%), used carboplatin. In the case group, cervix malignancy was the most common malignancy (32.3%), whereas in the control group, it was nasopharyngeal malignancy (25.8%). High soluble P-selectin level was a risk factor for DVT (OR 3.38, CI 1.180 – 9.780, p=0.02). A high NET level was also a risk factor for DVT (OR 2.88, CI 1.026-8.074, p=0.04). The high MPO levels in this study could not be proven as a risk factor. Conclusions Soluble P-selectin and NET are risk factors that play a role in the pathophysiology of DVT through the pathomechanism of immunothrombosis induced by endothelial injury and activation of monocytes and neutrophils due to the use of platinum-based chemotherapy.

Is Endometrial Receptivity Affected in Women With Endometriosis? Results From a Matched Pair Case-Control Study of Assisted Reproductive Technology Treatments

(Abstracted from Reprod Biomed Online 2023;47:103414 Endometriosis is a well-established risk factor for infertility due to alterations in folliculogenesis, oocyte release from the ovaries, tubal function, and oocyte fertilization. In addition, it has been hypothesized that the presence of an abnormal endometrium, a known consequence of endometriosis, may impair embryo implantation leading to impaired pregnancy outcomes.

Determinants of polycystic ovary syndrome: A matched case-control study.

Polycystic ovarian syndrome (PCOS) is a multifaceted endocrine disorder of women of reproductive age with a multifactorial aetiology. Despite much research, there is still inconclusive data on the impact of dietary, lifestyle and socio-economic factors on PCOS aetiology. Thus, the present study explored the association of PCOS with diet, eating behaviour, other lifestyle and socio-economic factors. A matched-pair case-control study was conducted on 150 women with PCOS and 150 healthy controls. Information on diet, eating behaviour and physical activity, and also anthropometric and socio-economic data were collected through standard questionnaires. The adjusted odds ratios (AmOR) were calculated and reported using conditional multivariable logistic regression. The results showed low education level (AmOR = 8.44; 95% confidence interval [CI] = 1.63-43.68), high sugar consumption (AmOR = 11.61; 95% CI = 2.05-65.72) along with higher body mass index (BMI) and inactivity to be significantly associated with PCOS. Also, a significant protective effect was found for cognitive dietary restraint (AmOR = 0.79; 95% CI = 0.66-0.93), crude fibre (AmOR = 0.61; 95% CI = 0.45-0.82) and protein intake. Low education status may contribute to higher receptiveness to choosing unhealthy diets and lifestyles, resulting in adiposity and an increased risk of PCOS.

A matched-pair case control study identifying hemodynamic predictors of cerebral aneurysm growth using computational fluid dynamics.

Introduction: Initiation and progression of cerebral aneurysms is known to be driven by complex interactions between biological and hemodynamic factors, but the hemodynamic mechanism which drives aneurysm growth is unclear. We employed robust modeling and computational methods, including temporal and spatial convergence studies, to study hemodynamic characteristics of cerebral aneurysms and identify differences in these characteristics between growing and stable aneurysms. Methods: Eleven pairs of growing and non-growing cerebral aneurysms, matched in both size and location, were modeled from MRA and CTA images, then simulated using computational fluid dynamics (CFD). Key hemodynamic characteristics, including wall shear stress (WSS), oscillatory shear index (OSI), and portion of the aneurysm under low shear, were evaluated. Statistical analysis was then performed using paired Wilcoxon rank sum tests. Results: The portion of the aneurysm dome under 70% of the parent artery mean wall shear stress was higher in growing aneurysms than in stable aneurysms and had the highest significance among the tested metrics (p = 0.08). Other metrics of area under low shear had similar levels of significance. Discussion: These results align with previously observed hemodynamic trends in cerebral aneurysms, indicating a promising direction for future study of low shear area and aneurysm growth. We also found that mesh resolution significantly affected simulated WSS in cerebral aneurysms. This establishes that robust computational modeling methods are necessary for high fidelity results. Together, this work demonstrates that complex hemodynamics are at play within cerebral aneurysms, and robust modeling and simulation methods are needed to further study this topic.

The roboticNICE procedure outperforms conventional laparoscopic extracorporeal-assisted colorectal resection: results of a matched cohort analysis.

We introduced the robotic NICE procedure for left-sided colorectal resection in 2018 in which the entire procedure is performed without loss of pneumoperitoneum and without an abdominal wall incision by performing natural orifice-assisted transrectal extraction of the specimen and intracorporeal anastomosis. We compare the results of the NICE procedure versus conventional laparoscopic resection, which was our standard approach prior to 2018. A matched pair case-control study compared patients following the NICE procedure versus those who underwent laparoscopic left-sided colorectal resection with conventional extracorporeal-assisted technique. Cases were performed at an Academic Medical Center and recorded in a prospective database to analyze perioperative outcomes. From a total cohort of 352 patients, 83 were matched in each group. When comparing the NICE procedure vs. the Extracorporeal-Assisted laparoscopic group, there were no significant differences in age (58.5 vs. 59.3years old), sex (47 vs. 42 Female), body mass index (27.4 vs. 27.5kg/m2), ASA, diagnosis, or type of surgery. Operative time (198.8 vs. 197.7min), blood loss (56.0 vs. 53.3ml), intraoperative complications (0.0% vs. 0.0%), and conversion rates (0.0% vs. 0.0%) were similar in both groups. The NICE procedure was associated with significantly earlier return of bowel function (40.7 vs. 23.6h), shorter length of stay (3.1 vs. 2.2days), and lower total opioid use (94.6 vs. 70.5 morphine milligram equivalents). Overall, there were no differences in postoperative abscess formation, complications, readmission, or reoperation rates. When compared to conventional laparoscopic resection, the NICE procedure is associated with short-term benefits including earlier recovery and less opioid use without increased operative time or increased risk of complications. Multicenter studies are recommended to validate benefits and limitations of this technique.

Sex selection drug and congenital malformations in North India

Background: An increasing incidence of congenital malformations (CMF) has been reported in North India in cases use of traditional drug by Mothers to have male child. Aim was to ascertain the association of Sex selection drug (SSD) and congenital malformations. Methods: This hospital-based age-sex matched pair case control study was done at Advanced Pediatric Centre, Obstretics and Gynaecology department (ANC clinic, Maternity ward, labor room etc.) and Special Clinics, PGIMER, Chandigarh, India in 2019. The mothers were interviewed to collect information about risk factors. Results: Two hundred three CMF (under five children and gestational CMF) cases and same number of controls were studied. Significant association of CMF was observed with the use of sex selection drugs by mothers (OR= 4.35). Conclusions: The use of sex selection drugs is an avoidable risk factor of CMF and is of high public health importance. People need to be educated about this.

Is endometrial receptivity affected in women with endometriosis? Results from a matched pair case-control study of assisted reproductive technology treatments

Research questionIs endometriosis detrimental to embryo implantation? DesignA retrospective matched case-control study of women with a surgical or ultrasound diagnosis of endometriosis at Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico di Milano between 2015 and 2021. Women with endometriosis who underwent a ‘freeze-all’ cycle during an IVF treatment were eligible to be included. They were matched to patients without the disease, who also underwent cryopreserved blastocyst transfer cycles, in a 1:1 ratio by age (±1 year), and number (=) and quality (±1 top versus low) of cryopreserved blastocysts. All women underwent single frozen embryo transfer, and assisted reproductive technology outcomes suggested by the Core Outcome Measure for Infertility Trials initiative were evaluated. The main outcome was the cumulative live birth rate per cycle. ResultsOne hundred and one women with endometriosis and 101 matched unaffected women were included. Cumulative live birth rate per cycle did not vary between women with and without endometriosis (50% versus 58%, respectively; P = 0.32). On the basis of the Kaplan–Meier analysis, the predicted success rates over four embryos transferred were also similar (74% versus 82%, respectively; P = 0.67). ConclusionIn women with moderate or severe endometriosis, these retrospective results seem to indicate no or a limited effect of the disease on endometrial receptivity.

Clinical Outcomes of Isobar TTL System with Isthmic Bone Grafting and Pedicle Screw-Vertebral Plate Hook with Direct Repair of Defect for Lumbar Spondylolysis: A Matched-Pair Case Control Study.

Although direct isthmic repair, such as PSVPH, did not affect the mobility of the fixed segment and adjacent segment, it has a relatively low rate of isthmic fusion compared with conventional fusion. The Isobar TTL dynamic internal fixation system has been widely used in clinical practice and has achieved satisfactory clinical results. However, the use of the Isobar TTL system in combination with direct isthmic repair for lumbar spondylolysis has rarely been reported. The aim of this study was to compare the clinical and radiologic outcomes between patients who underwent Isobar TTL system and PSVPH with direct repair of defect for lumbar spondylolysis. Stepwise propensity score matching (PSM) for age and sex were performed to keep comparable clinical data between groups in this retrospective and matched-pair case control study. A total of 50 patients diagnosed with lumbar spondylolysis underwent surgical implantation of the Isobar TTL group (n = 25) or PSVPH group (n = 25) from June 2009 to June 2016. Clinical outcomes were assessed using the Oswestry disability index (ODI), and visual analog score (VAS). Radiographic evaluations included range of motion (ROM) and the disc heights of stabilized segment and adjacent segment, adjacent segment degeneration (ASD) and bony fusion. Three-dimensional reconstruction of lumbar CT scan was obtained to evaluate bone fusion of the isthmic at final follow-up. The independent Student's t test and chi-square test were applied to compare the differences between groups. A total of 25 patients from TTL group were matched to 25 patients in PSVPH group for age, sex, body mass index (BMI), defect side, spondylolisthesis meyerding, and follow-up duration. The intervertebral space height (IH) of stabilized segment at postoperative 1 week and final follow-up in the TTL group was higher than those in the PSVPH group, respectively (P = 0.030; P = 0.013). The ROM of stabilized segment at final follow-up in the TTL group was significantly lower than that in the PSVPH group (P < 0.001). The bony fusion rate at the final follow-up was 88.0% (22/25 cages) in the TTL group and 80.0% (20/25 cages) in the PSVPH group. The ODI score at final follow-up in the TTL group was significantly lower than that in the PSVPH group (P = 0.007). Overall, our data suggest that the Isobar TTL system outcomes are comparable to those in the PSVPH, with a similar high bony fusion rate as PSVPH, especially its wider indications as a new surgery.

Does Preoperative Modic Changes Influence the Short-term Fusion Rate of Single Level Transforaminal Lumbar Interbody Fusion?-a Matched-pair Case Control Study.

At present, the influence of Modic changes (MCs) on postoperative fusion rate of lumbar interbody fusion (LIF) is mainly focused on the medium- and long-term fusion rate, while the short-term fusion rate has not been reported. The aim of this study was to compare the short-term fusion rate of lumbar degenerative disease patients with and without MCs after single level transforaminal lumbar interbody fusion (TLIF). In this retrospective and matched-pair case control study, we included 100 patients who underwent TLIF from January 2017 to January 2020 and had at least two follow-up visits over a two-year period. Fifty patients with MCs (MCs group) were matched with 50 patients without MCs (non MCs group) for age, sex, surgical level, diagnosis, operative time, and intraoperative blood loss. We collected the X-ray and computed tomography (CT) data of patients from 3 months to 2 years after the operation to assess bony fusion and the cage union ratio. According to the type of cage, the MCs group was further divided into the nano-hydroxyapatite/polyamide 66 (n-HA/PA66) group and polyetheretherketone (PEEK) group, and the fusion performance between the two groups was compared. Finally, age, sex, body mass index (BMI), smoking and cage type were included in the logistic regression model for risk factor analysis. The bony fusion rates in the MCs group at 3 months, 6 months, 1 year and 2 years after surgery were significantly lower than those in the non MCs group (P < 0.05) (23.8% vs 62.5%, 52.6% vs 78.9%, 61.1% vs 83.3%, 74.0% vs 90.0%). The average coronal cage union ratios of the upper and lower endplates in the MCs group were significantly lower than those in the non MCs group (54.3% ± 17.5% vs 75.0% ± 17.2%, P < 0.05; 73.3% ± 12.0% vs 84.9% ± 8.0%, P < 0.05). Similarly, analogous results were obtained by comparing the MCs and non MCs groups' three-dimensional CT sagittal plane images (62.5% ± 16.5% vs 76.1% ± 12.4%, P < 0.05; 67.0% ± 13.9% vs 79.8% ± 11.5%, P < 0.05). Short-term fusion rates were lower in the MCs group than in the non MCs group. The coronal and sagittal cage union ratio in the MCs group was lower than that in the non MCs group. The fusion performance of n-HA/PA66 and PEEK cages in the MCs group was comparable.

P-328 Endometrial receptivity in women with endometriosis undergoing Assisted Reproductive Technology (ART) after frozen embryo transfer: a matched pair case-control study

Abstract Study question Does endometriosis affect endometrial receptivity in frozen/thawed embryo transfer (FET) cycles? Summary answer Stage III/IV endometriosis-patients undergoing ART submitted to FET cycles have implantation, pregnancy and live-birth rates, as well as pregnancy outcomes, similar to control women. What is known already The increased infertility rate observed in women with endometriosis is supposed to be linked, among other factors, to molecular alterations already documented in the endometrial tissue of these affected women. These alterations might influence the interaction between the embryo and the endometrium, leading to a compromised implantation; however, data from the literature are controversial and do not always corroborate the hypothesis of a lower implantation rate in women with endometriosis. Study design, size, duration This is a retrospective matched case-control study including 101 women diagnosed with stage III/IV endometriosis. They were matched in a 1:1 ratio with patients undergoing frozen embryo transfers after ART treatments for other infertility-related indications at the Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico di Milano, between 2015 and 2022. Participants/materials, setting, methods Patients (n = 202) were submitted to ovarian stimulation according to standard protocols and only single embryo transfer cases and the 1st ART cycle with freeze-all protocol were included. To match, it was considered the women's age ( ± 1 year), and the number ( = ) and quality ( ± 1 top vs low) of blastocysts obtained in each cycle, considering the Istanbul consensus as the embryo standard assessment protocol. The main outcome evaluated in this study was implantation rate. Main results and the role of chance Baseline characteristics did not significantly vary between the two study groups, except for AMH levels, which was considerably lower in the endometriosis group compared to control (4.0 [2.7 - 5.4] vs 4.6 [3.7 - 6.5], respectively; p = 0.03). Considering the treatment outcomes, the number of oocytes inseminated/injected in each cycle was similar between endometriosis and control group (8 [7 - 10] vs 9 [7 - 11], respectively; p = 0.26). In line with the matching performed, the number of blastocysts generated did not differ between women with and without endometriosis (3 [2 - 4] vs 3 [2 - 4], respectively; p = 1.00), as well as the number of top-quality blastocysts (2 [1 - 3] vs 2 [1 - 3], respectively; p = 0.76). In regard to our main outcome evaluated, implantation rate in women with endometriosis and their controls were similar (36% vs 40%, respectively; p = 0.52). There was also no difference between the endometriosis group and controls considering cumulative pregnancy outcomes, such as pregnancy rate (58% vs 65%, respectively; p = 0.39), cumulative live birth rate (51% vs 59%, respectively; p = 0.26), pregnancy complications (6% vs 14%, respectively; p = 0.34), and pregnancy loss (16% vs 19%, respectively; p = 0.70). Limitations, reasons for caution As it is a retrospective study, our reports might be subjected to misclassification bias. Also, some of the women in the control group may have asymptomatic undiagnosed endometriosis; however, considering the incidence of this disease, it should not compromise our evaluation. Wider implications of the findings Our present findings give support to the idea that endometriosis does not influence the implantation rate in women with endometriosis undergoing ART submitted to FET. Considering fertility, this finding raises doubts about the clinical relevance of the molecular aberrations detected in the endometrium of women affected by endometriosis. Trial registration number not applicable

Association of glucagon-like peptide-1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy.

Previous studies have reported that the glucagon-like peptide-1 receptor agonist (GLP-1RA) delays gastric emptying, and gastric emptying was assessed by the 13 C breath test or paracetamol absorption technique. However, neither of them is clinically familiar in real-world clinical practice. The purpose of the present study was to investigate the association between GLP-1RA treatment and gastric residue in an esophagogastroduodenoscopy. This study was a matched pair case-control study. The study population consisted of 1,128 individuals with diabetes who had esophagogastroduodenoscopy at our clinic between July 2020 and June 2022. To account for differences in characteristics, such as age, sex, insulin treatment and glycated hemoglobin, we carried out a one-to-one nearest neighbor propensity score matching analysis between diabetes patients with and without GLP-1RA treatment. After matching, we compared the presence of gastric residue in an esophagogastroduodenoscopy by the McNemar test between patients with and without GLP-1RA treatment. After the propensity score matching, we selected 205 pairs. In the propensity score-matched comparison, the proportion of gastric residue was statistically significantly higher in the GLP-1RA treatment group (0.49% vs 5.4%, P=0.004). The details of GLP-1RA prescribed for the 11 patients with gastric residue were liraglutide once daily 1.8 mg (n=2), dulaglutide once weekly 0.75 mg (n=5), semaglutide once weekly 0.5 mg (n=2) and semaglutide once weekly 1.0 mg (n=2). GLP-1RA treatment is associated with gastric residue in an esophagogastroduodenoscopy in patients with diabetes.

Maternal Plasma Lipid Profile and Risk of Spontaneous Preterm Labor Study in a Sample of Iranian Women in 2019.

Neonatal problems and adverse outcomes may be minimized by up to 90-75% when preterm delivery is diagnosed early and managed properly. This study aimed to determine the association of maternal plasma lipid indices with the occurrence of spontaneous preterm labor. This matched pair case-control study was performed on 80 pregnant women referred to a teaching hospital in Tehran for childbirth in 2019. The lipid profile was assessed in women with spontaneous preterm labor and term birth. According to age, Body Mass Index (BMI), pregnancy number, employment status, and educational level, the women in each group were paired. Data were analyzed using an independent-samples t-test, Mann-Whitney U-test, Chi-square, linear regression, and conditional logistic regression. Mean serum levels of total cholesterol, triglycerides, and low-density lipoprotein were all significantly higher in the case group compared with the control group (p < 0.05). The conditional logistic regression test confirmed that this association remained significant even after adjusting the effect of potentially confounding factors such as maternal age and body mass index. In addition, in linear regression the increased levels of triglyceride, total cholesterol, and low-density lipoprotein were found to be associated with 3.33-fold (1.32.-5.32 95% CI, p < 0.001), 2.94-fold (1.60-3.14 95% CI, p = 0.002), and 2.46-fold (1.31.-2.91 95% CI, p = 0.006) increased risk of preterm labor, respectively. High triglyceride, total cholesterol, and low-density lipoprotein serum levels may be linked to an increased chance of spontaneous preterm labor, which might be considered a risk factor for this pregnancy problem.

Health-related quality of life in patients with gastric cancer: case-control study

Cancer has a great impact on the quality of life in terms of physical, mental, and social functions and affects the quality of life of patients. The aim of the study was to compare healthrelated quality of life (HRQL) in patients with gastric cancer to that of the general population and to analyze the impact of gastric cancer on quality of life by all subscale components. The matched pair case-control study was performed. The Case group of 50 patients with gastrointestinal cancer was compared with the control group of 50 study participants without cancer, to whom the EORTC QLQ-C30 questionnaire was similarly applied. The results showed a decrease of HRQL in many aspects for patients with cancer compared to those without cancer. According to functional scales, role and emotional functioning were found lower in patients with cancer by more than 20 points, qualified as major clinical interest change (p &lt; .001). According to the symptoms scale, only in the occurrence of pain do we observe major HRQL decline in patients with cancer (p &lt; .001). Financial difficulties were also identified for a major decrease in HRQL in cancer patients (p &lt;.001). It is concluded that patients with cancer report a lower HRQL predominantly related to the social and psychological aspects than to the cancer disease somatic conditions. In clinical care, it should be considered that the majority of cancer patients are quite concerned about their emotional and role functioning. Efforts to reduce these worries should be made in decision-making with clinicians while making care more patient-centered in order to improve their HRQL.

High plasma H2O2 level and low plasma catalase level as risk factors for acne vulgaris

Background: In this recent time, ROS and oxidative stress have been said to play an important role in the pathogenesis of inflamed acne lesions. One example of ROS produced by neutrophil through phagocytosis is H2O2. Nevertheless, there is an enzymatic antioxidant which catalyses H2O2 called catalase. Imbalance of free radicals and antioxidants due to excessive ROS formation promotes the state of oxidative stress and inflammation of the acne lesion.&#x0D; Objective: This study aimed to determine plasma H2O2 and catalase level as a risk factor for acne.&#x0D; Methods: This matched-pair case-control observational analytic study involving 38 patients with acne and 38 patients without acne. Sampling was done using consecutive sampling which fulfils the inclusion and exclusion criteria and followed by matching with age and gender. H2O2 and catalase level measured on both groups. The analysis was done using SPSS.&#x0D; Results: H2O2 mean level in the case and control group, respectively 0.68 ± 0.03 and 0.42 ± 0.04 µmol/ml. High H2O2 level was determined from cut-off point &gt;0.62 µmol/ml. High H2O2 was a statistically significant risk factor for acne vulgaris (p&lt;0.001; 95% CI: 4.59-40.62; OR: 13.67). The mean level of catalase in the case and control group respectively 0.48 ± 0.06 and 0.74 ± 0.07 U/ml. Low catalase level was determined from the cut-off point &lt;0.58 U/ml. Catalase was significant risk factor for acne vulgaris (p&lt;0.001; 95% CI: 5.18-77.21; OR: 20.00).&#x0D; Conclusion: High levels of H2O2 plasma and low levels of catalase plasma is a risk factor of acne vulgaris.

High plasma dopamine level as a risk factor for atopic dermatitis

Background: Dopamine is responsible for inflammatory response and plays a role in the skin immune system by modulating T-cells, dendritic cells, and keratinocytes which increases skin inflammatory response in atopic dermatitis (AD). Elevation of dopamine level will affect IL-6, IL-8, IL-23, Th-17, and TNF-α, which promotes keratinocyte proliferation and differentiation, infiltration of inflammatory cells, angiogenesis, vasodilation, and skin barrier disruption on AD.&#x0D; Objective: This study aimed to establish whether the increase of plasma dopamine level contributes to a risk factor for AD occurrence.&#x0D; Methods: This is a matched-pair case-control observational analytical study which involves patients with AD and without AD as control. Samples were taken using a consecutive sampling method which fulfilled inclusion and exclusion criteria, matched for gender and age. Plasma dopamine level was measured from venous blood and processed using enzyme-linked immunosorbent assay (ELISA) method. The collected data were then analysed using SPSS version 20.0 with Pearson chi-square test for the odds ratio.&#x0D; Results: A total of 30 samples with AD (case group) and 30 samples without AD (control group) involved in this study. This study proves that plasma dopamine levels in the case group were significantly higher than the control group (p&lt;0.05). Odds ratio for plasma dopamine was 42.2 (95%CI: 9.5-187.2, p &lt; 0.001).&#x0D; Conclusion: This study concludes that high plasma dopamine level is a risk factor for AD.

Comparison of Long-Term Outcomes between the n-HA/PA66 Cage and the PEEK Cage Used in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Matched-Pair Case Control Study.

The nanohydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel bioactive nonmetal cage that is now used in some medical centers, while the polyetheretherketone (PEEK) cage is a typical device that has been widely used for decades with excellent clinical outcomes. This study was performed to compare the long-term radiographic and clinical outcomes of these two different cages used in transforaminal lumbar interbody fusion (TLIF). In this retrospective and matched-pair case control study, we included 200 patients who underwent TLIF from January 2010 to December 2014 with a minimum 7-year follow-up. One hundred patients who used n-HA/PA66 cages were matched with 100 patients who used PEEK cages for age, sex, diagnosis, and fusion level. The independent student's t-test and Pearson's chi-square test were used to compare the two groups regarding radiographic (fusion status, cage subsidence rate, segmental angle [SA], and interbody space height [IH]) and clinical (Oswestry Disability Index [ODI], and Visual Analog Scale [VAS] for back and leg) parameters preoperatively, postoperatively, and at the final follow-up. The n-HA/PA66 and PEEK groups had similar fusion rates of bone inside and outside the cage at the final follow-up (95.3% vs 91.8%, p=0.181, 92.4% vs 90.1%, p=0.435). The cage union ratios exposed to the upper and lower endplates of the n-HA/PA66 group were significantly larger than those of the PEEK group (p < 0.05). The respective cage subsidence rates in the n-HA/PA66 and PEEK groups were 10.5% and 17.5% (p=0.059). There were no significant differences between the two groups in the SA, IH, ODI scores, or VAS scores at any time point. The n-HA/PA66 group showed high fusion and low subsidence rates during long-term follow-up. Both n-HA/PA66 and PEEK cages can achieve satisfactory long-term clinical and radiographic outcomes in TLIF. However, the n-HA/PA66 group showed significantly larger cage union ratios than the PEEK group. Therefore, the results indicated that the n-HA/PA66 cage is an ideal alternative material comparable to the PEEK cage in TLIF.

Associations between Deformation of the Thoracolumbar Fascia and Activation of the Erector Spinae and Multifidus Muscle in Patients with Acute Low Back Pain and Healthy Controls: A Matched Pair Case-Control Study.

The thoracolumbar fascia (TLF) is thought to play a role in the development of LBP, but it is not yet clear which factor of TLF changes is a cause and which is an effect. Therefore, some studies used the cross-correlation function (CCR) to reveal time-dependent relationships between biomechanical and neuromotor factors. Ten patients with acute low back pain (aLBP) were matched to healthy controls. Simultaneous recording of surface electromyography (sEMG) of the erector spinae and multifidus muscle (ESM) and dynamic ultrasound (US) images of TLF deformation were performed during trunk extension. CCR functions and Granger causality (GC) were used to describe the relationship between the two measures. CCR time lags were significant higher in the aLBP group (p = 0.04). GC showed a direct effect of TLF deformation on ESM activation only in the aLBP group (p &lt; 0.03). The results suggest that in aLBP, ESM activity is significantly affected by TLF, whereas this relationship is completely random in healthy subjects studied with CCR and GC comparisons of dynamic US imaging and sEMG data signals. Fascia-related disturbances in neuromotor control, particularly due to altered muscle spindle functions, are suspected as a possible mechanism behind this.

Skin-to-skin SDF positioning: The key to intersubjective intimacy between mother and very preterm newborn-A pilot matched-pair case-control study.

BackgroundSkin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits, for both the baby and the parent. However, very few studies have investigated SSC’ benefits for communication, in particular in the very-preterm newborn immediately after birth.AimsTo investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother—very-preterm newborn communication and to examine the coordination of the timing of communicative behaviors, just a few days after birth.Subjects and study designMonocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA, mean age at birth: 30 weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control positioning (n = 17) or the SDF Intervention positioning (n = 17). Mother and newborn were filmed during the first 5 min of their first SSC.Outcome measuresInfants’ states of consciousness according to the Assessment of Preterm Infants’ Behavior scale (APIB). Onset and duration of newborns’ and mothers’ vocalizations and their temporal proximity within a 1-s time-window.ResultsIn comparison with the Vertical group, very preterm newborns in the SDF Intervention Group spent less time in a drowsy state and more in deep sleep. At 3.5 days of life, newborns’ vocal production in SSC did not differ significantly between the two groups. Mothers offered a denser vocal envelope in the SDF group than in the Vertical group and their vocalizations were on average significantly longer. Moreover, in a one-second time-frame, temporal proximity of mother-very preterm newborn behaviors was greater in the SDF Intervention Group.ConclusionAlthough conducted on a limited number of dyads, our study shows that SDF positioning fosters mother-very preterm newborn intimate encounter during the very first skin to skin contact after delivery. Our pioneer data sheds light on the way a mother and her very preterm vocally meet, and constitutes a pilot step in the exploration of innate intersubjectivity in the context of very preterm birth.

Uncontrolled diabetes mellitus exacerbated by COVID-19-induced inflammation is the risk factor for COVID-19-associated rhino-orbito-cerebral mucormycosis: A matched pair case-control study.

Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for developing COVID-19-associated ROCM, comparing the risk factors among COVID-19 patients with and without ROCM. This case-control study included all COVID-19-associated ROCM patients treated at our hospital from May 1 to July 30, 2021. Controls included age- and sex-matched COVID-19 patients without ROCM, who were treated during the same time (exact matching, in 1:2 ratio). Matched pair analysis using conditional logistic regression was performed to examine the association of various risk factors with the development of ROCM in COVID-19 patients. The study included 69 patients with COVID-19-associated ROCM and 138 age- and gender-matched controls. Epidemiologically, COVID-19-associated ROCM predominantly affected males (59/69, 85%), in their early 50s (mean 52 years), with 48% (33/69) of patients being from medical resource-constrained settings. On multivariate conditional logistic regression, elevated serum glycated hemoglobin (HbA1c) (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.03-1.78), blood glucose (OR = 1.008, 95% CI: 1.003-1.013), and C-reactive protein (CRP) (OR = 1.07, 95% CI: 1.02-1.17) were associated with increased odds of developing COVID-19-associated ROCM. Patients with undetected diabetes mellitus with increasing HbA1c (OR = 3.42, 95% CI: 1.30-9.02) and blood glucose (OR = 1.02, 95% CI: 1.005-1.03) (P = 0.02) had a higher probability of developing COVID-19-associated ROCM than patients with established DM. Uncontrolled DM evidenced by elevated HbA1c and blood glucose levels, exacerbated by COVID-19-induced proinflammatory state indicated by elevated CRP, is the principal independent risk factor for COVID-19-associated ROCM. Middle-aged males with undetected DM, from a resource-constraint setting, are particularly at risk.

Influence of type 2 diabetes mellitus on mortality in women with breast cancer: A matched case-control study

AimsThe study assessed the association between the presence of type2 diabetes mellitus (T2DM) and mortality in women with breast cancer (BC). MethodsA matched pair case-control study was conducted at the State Cancer Center, which is located in Xalapa, Veracruz, Mexico. It was matched by age (±3 years) within a cohort of 1442 patients with BC. Descriptive statistics were performed. Analysis through paired odds ratio (OR and multivariate analyses were used to calculate the association between BC mortality and the variables studied. Results166 cases and 166 controls with confirmed diagnosis of BC were studied, with a mean age of 52.9 ± 11.9 years. The T2DM was associated with an increased mortality of women with BC (OR = 1.75 95 %CI 1.06–2.89). Similarly, metastasis (OR = 14.17 95 %CI 6.19–32.342), advanced clinical stage (OR = 3.04 95 %CI 1.45 - 6.38), and the molecular subtypes Her2 (OR = 2.0 95 %CI 1.02–3.92), and triple negative (OR = 3.54 95 %CI 1.72–7.32). There was no difference in mean glucose between cases and controls (208.9 ± 132 vs 194.4 ± 90.4 mg/dL, respectively). ConclusionT2DM was found to be a relevant risk factor for BC mortality in this Mexican population. Thus, it is important to consider the presence and evolution of DM in the prevention programs, diagnostic algorithms and treatments established for BC.