Odds Radio Research Articles

Predictors of COVID-19 Infection: A Prevalence Study of Hospitalized Patients.

Aim To find the predictors of coronavirus disease 2019 (COVID-19) in hospitalized patients. Methods A prevalence study compared the characteristics of COVID-19 patients with non-COVID-19 patients from January 19, 2020, to February 18, 2020, during the COVID-19 outbreak. Laboratory test results and pulmonary chest imaging of confirmed COVID-19 and non-COVID-19 patients were collected by retrieving medical records in our center. Results 96 COVID-19 patients and 122 non-COVID-19 patients were enrolled in this study. COVID-19 patients were older (53 vs. 39; P < 0.001) and had higher body mass index (BMI) than non-COVID-19 group (24.21 ± 3.51 vs. 23.00 ± 3.27, P = 0.011); however, differences in gender were not observed between the two groups. Logistic regression analysis showed that exposure history (OR: 23.34, P < 0.001), rhinorrhea (odds radio (OR): 0.12, P = 0.006), alanine aminotransferase (ALT) (OR: 1.03, P = 0.049), lactate dehydrogenase (LDH) (OR: 1.01, P = 0.020), lymphocyte (OR: 0.27, P = 0.007), and bilateral involvement on chest CT imaging (OR: 23.01, P < 0.001) were independent risk factors for COVID-19. Moreover, bilateral involvement on chest CT imaging (AUC = 0.904, P < 0.001) had significantly higher AUC than others in predicting COVID-19. Conclusions Exposure history, elevated ALT and LDH, absence of rhinorrhea, lymphopenia, and bilateral involvement on chest CT imaging provide robust evidence for the diagnosis of COVID-19, especially in resource-limited conditions where nucleic acid detection is not readily available.

Gender Disparities in Anti-dementia Medication Use among Older Adults: Health Equity Considerations and Management of Alzheimer's Disease and Related Dementias.

Objective: The prevalence of Alzheimer’s disease and related dementias (ADRD) in women is higher than men. However, the knowledge of gender disparity in ADRD treatment is limited. Therefore, this study aimed to determine the gender disparities in the receipt of anti-dementia medications among Medicare beneficiaries with ADRD in the U.S.Methods: We used data from the Medicare Current Beneficiary Survey 2016. Anti-dementia medications included cholinesterase inhibitors (ChEIs; including rivastigmine, donepezil, and galantamine) and N-methyl-D-aspartate (NMDA) receptor antagonists (including memantine). Descriptive analysis and multivariate logistic regression models were implemented to determine the possible gender disparities in the receipt of anti-dementia medications. Subgroup analyses were conducted to identify gender disparities among beneficiaries with Alzheimer’s disease (AD) and those with only AD-related dementias.Results: Descriptive analyses showed there were statistically significant differences in age, marital status, and Charlson comorbidities index (CCI) between Medicare beneficiaries who received and who did not receive anti-dementia medications. After controlling for covariates, we found that female Medicare beneficiaries with ADRD were 1.7 times more likely to receive anti-dementia medications compared to their male counterparts (odds ratio [OR]: 1.71; 95% confidence interval [CI]: 1.19–2.45). Specifically, among Medicare beneficiaries with AD, females were 1.2 times more likely to receive anti-dementia medications (Odds Radio: 1.20; 95% confidence interval: 0.58–2.47), and among the Medicare beneficiaries with only AD-related dementias, females were 1.9 times more likely to receive anti-dementia medications (OR: 1.90; 95% CI: 1.23–2.95).Conclusion: Healthcare providers should be aware of gender disparities in receiving anti-dementia medications among patients with ADRD, and the need to plan programs of care to support both women and men. Future approaches to finding barriers of prescribing, receiving and, adhering to anti-dementia medications by gender should include differences in longevity, biology, cognition, social roles, and environment.

Serum growth differentiation factor 15 is closely associated with metabolic abnormalities in Chinese pregnant women.

AimsTo explore the relationship between serum growth differentiation factor 15 (GDF15) and metabolic abnormalities in Chinese pregnant women.Materials and MethodsWe recruited 200 patients with gestational diabetes mellitus (GDM) and 211 matched normal control within 24–28 weeks of pregnancy. Enzyme‐linked immunosorbent assay (ELISA) was used to determine the serum GDF15 levels of all participants. Then we grouped participants according to the number of metabolic abnormalities (including blood glucose, blood lipids and blood pressure), divided them into a normal metabolic group, one metabolic abnormality group, two or more metabolic abnormalities group. Finally, multinomial logistic regression analysis was used to estimate the odds radio (OR) and 95% CIs expressing the association between GDF15 and metabolic abnormalities in pregnant women.ResultsThrough bivariate correlation analysis, we found that serum GDF15 is linearly correlated with glucose metabolism indices, such as 1h‐PG, 2h‐PG, HbA1c (all P < 0.05). In addition, serum GDF15 and triglycerides were linearly correlated (P < 0.05). Grouping by the number of metabolic abnormalities, we found that as GDF15 levels increased, the risk of metabolic abnormalities also increased (OR > 1), and the risk of multiple metabolic abnormalities was higher. As the number of metabolic abnormalities increased, serum GDF15 levels also were elevated (P < 0.001).ConclusionsThe results suggest that serum GDF15 levels are closely associated with metabolic abnormalities in pregnant women and may be used as a predictor of metabolic abnormalities during pregnancy.

Dyslipidemia in Pregnancy and the Proper Reference Values: A Retrospective Study in South China

Background: Dyslipidemia during pregnancy is associatied with the risk of adverse pregnancy outcomes. However, there is no uniform diagnostic criteria. “Williams Obstetrics 24th Edition” (WO24) and Wang et al gave different lipid references based on ethnic groups. To address the proper reference values of pregnant lipid, we conducted this retrospective study in pregnant women in South China. Methods: 642 pregnant women were calculated the normal lipid range by 95th percentile and analyzed the association between lipid levels and adverse pregnancy outcomes by logistic regression models. Prevalence of adverse pregnancy outcomes in dyslipidemia patients diagnosed by the three different references were compared by Pearson’s chi-squared (χ2) test. Results: The prevalence of dyslipidemia were 15.26% by the references of our research, 11.53% by WO24, and 17.45% by Wang, respectively. TC level was the risk factor of preterm birth (PTB); and TG level was associated with the risk of gestational diabetes mellitus (GDM) and PTB. The odds radio (OR) for GDM in patients with abnormal TG levels were 4.28[1.28-14.28] by WO24’s, 3.06[1.43-6.57] by ours, and 2.62[1.13-6.11] by Wang's. The OR for PTB in patients with abnormal TG levels were 4.22[1.21-14.69] by WO24’s, 3.04[1.22-7.62] by Wang’s, and 2.31 [0.95-5.63] by ours. A increased risk of macrosomia was only seen in patients with abnormal TC level by Wang's reference (OR 3.67 [1.12-12.06]). Conclusions: Dyslipidemia during pregnancy is associated with the increases of pregnant complications. The reference by Wang et al were more applicable in Southern China.

Incidence and Risk of PD-1/PD-L1 Inhibitor-associated Pneumonia in Advance Cancer Patients: A Meta-analysis

背景与目的免疫检查点抑制剂（immune checkpoint inhibitor, ICI）对绝大多数晚期肿瘤具有良好的疗效，给晚期肿瘤患者带来了新的希望，然而由ICI激活的免疫系统，可能攻击人体正常组织器官导致相应的免疫毒性，如ICI相关肺炎。本研究对程序性细胞死亡受体1（programmed cell death protein 1, PD-1）抑制剂及程序性细胞死亡受体配体1（programmed cell death protein ligand 1, PD-L1）抑制剂在晚期肿瘤患者中的相关肺炎发生率和发生风险进行荟萃分析。方法计算机检索PubMed、Cochrane Library、EMbase、中国知网数据库，收集PD-1/PD-L1抑制剂在晚期肿瘤患者中相关肺炎发生率的研究，检索时限为2000年1月-2020年1月。用Revman 5.3软件及R 3.6.2软件进行统计学分析比较不同情况下的肺炎发生率。结果共纳入15篇研究，包含8, 642例患者。其中治疗组为PD-1或PD-L1抑制剂，对照组为化疗组，所有级别免疫性肺炎发生率的风险比（odds ratio, OR）为6.63，而高级别为4.87；ICI组非小细胞肺癌中所有级别肺炎发生率是其他瘤种的1.658倍，而高级别肺炎为2.299倍；二线及以上应用ICI所有级别肺炎的发生率是一线的0.489倍，且高级别肺炎的发生率是一线及以上应用ICI的0.449倍。结论与化疗相比，PD-1和PD-L1抑制剂发生相关肺炎的风险较高，在ICI组中非小细胞肺癌以及一线应用中有较高发生风险。本研究为晚期肿瘤的临床治疗用药及并发症防治提供指导依据。

Risk of cervical and vaginal dysplasia after surgery for vulvar intraepithelial neoplasia or cancer: A 6 year follow-up study

ObjectivesTo estimate the frequency of abnormal surveillance cytology leading to high-grade dysplasia after surgical management for high-grade vulvar intraepithelial neoplasia (VIN) and vulvar cancer and to determine whether prior hysterectomy reduces this risk. MethodsWomen who underwent surgery for high-grade VIN or vulvar cancer between 2006 and 2014 were identified retrospectively. Patients who underwent prior hysterectomy for any indication were included. Univariate and multivariate logistic regression analyses were used to identify clinical correlates of abnormal cytology after surgical treatment for VIN and vulvar cancer. ResultsDuring a median follow-up for 72 months, 302 women underwent surveillance with cytologic screening after vulvar surgery including 99 (33%) women with prior hysterectomy. 75 (25%) women had abnormal cytology results. Of those, 47 (63%) were low-grade and 28 (37%) were high-grade, including 2 (3%) cases of invasive cancer. The rates of high-grade vaginal intraepithelial neoplasia (VAIN), cervical intraepithelial neoplasia (CIN), or cancer were not significantly different despite prior hysterectomy (9% VAIN 2+, 7% CIN 2+). Multivariate analysis showed that correlates of high-grade cytology following treatment for VIN or vulvar cancer included non-white race [odds radio (OR) 3.6, 95% confidence interval (CI) 1.7–7.8], prior abnormal cytology (OR 3.5, 95% CI 1.6–7.6), and immunodeficiency (OR 3.4, 95% CI 1.3–8.8). Prior hysterectomy did not significantly decrease risk of high-grade cytology (OR 0.87, 95% CI 0.5–1.6). ConclusionsWomen treated surgically for VIN/vulvar cancer have an 8% risk of at least high-grade dysplasia from surveillance screening and prior hysterectomy does not mitigate the risk. Extrapolating from current guidelines, we recommend surveillance cytology screening at least 6–12 months after treatment.

Association of polymorphisms in grainyhead-like-2 gene with the susceptibility to age-related hearing loss: A systematic review and meta-analysis.

Objective:The grainyhead-like-2 (GRHL2) genetic variants were reported in age-related hearing impairment (ARHI) susceptibility in several case–control studies. However, their conclusions are conflicting; it is difficult to precisely assess the disease risk associated with the variants. Therefore we conduct the meta-analysis to discover the association of GRHL2 polymorphisms and the risk of ARHI.Methods:A related literature search was conducted in on-line databases, such as Wanfang database, China National Knowledge Infrastructure (CNKI), EMBASE, Web of Science, and PubMed (updated to August 30, 2018). We use Review Manager 5.0 and Stata SE 12.0 software to reckon the odds radio (OR), 95% confidence interval (CI) and P value in random- or fixed-effects model according to the I2 value in the heterogeneity test.Results:2762 cases and 2321 controls in 5 articles were provided data to the meta-analysis. The pooled ORs (95% CI) of the rs10955255 polymorphism were 1.26 (1.05–1.50, P = .01), 1.33 (1.07–1.65, P = .01), and 1.32 (1.12–1.55, P = .0007) in the allele, homozygote and recessive model separately. Besides, a significant association was detected between rs1981361 in mixed population and the ARHI risk in the allele, heterozygote, and dominant genetic model respectively. Then subgroup analyses was performed by ethnicity, for rs10955255 meaningful associations were detected for the allele model, homozygote model, dominant model and recessive model in the Caucasian population but no relations in any of the 5 genetic models in Asian population.Conclusion:The meta-analysis indicated that the rs10955255 polymorphism could be an important risk factor for ARHI, especially in the Caucasians. The rs1981361 polymorphism may be a risk factor for ARHI in Asians. Larger scale researches are needed to further bring the consequences up to date.

Chemotherapy-related outcomes in triple-negative breast cancer.

e12049 Background: Triple-negative breast cancer (TNBC) is associated with a poor prognosis when compared to hormone receptor positive breast cancers. Anthracycline-based regimens (ABRs) are mainstays of treatment for non-metastatic TNBC. However, anthracyclines are associated with an increased risk of potentially life-threatening adverse effects. We sought to compare survival outcomes in patients with early TNBC treated with ABRs versus those treated with anthracycline-sparing regimens (ASRs). Methods: All patients treated for stage I-III TNBC who had undergone curative-intent surgery at a large academic medical center between January 2013-May 2018 were included in the study. Event-free survival (EFS) and disease-free survival (DFS) were the primary endpoints, with overall survival (OS) as a secondary endpoint and were defined as per standardized STEEP criteria. Kaplan-Meier, multivariable Cox regression, and log-rank tests were used to define key survival and treatment related differences between subjects treated with ABRs vs ASRs. Results: 137 patients met inclusion criteria with a median follow-up of 39 months. 21 patients (15%) recurred and 16 (12%) died. Patients treated with ABRs (n = 26, 19%) compared with ASRs (n = 111, 81%) had significantly shorter median EFS (38 months vs not-yet-reached, NYR, p &lt; 0.001), DFS (37 months vs NYR, p &lt; 0.001), and OS (50 months vs NYR, p &lt; 0.001). Though patients in the ABR vs the ASR group were more likely to be node-positive (Odds Radio 3.46, p = 0.006), shorter survival estimates in the ABR group were observed after adjusting for nodal status. 27% of patients (7/26) had an anthracycline added after suboptimal response to an ASR. After adjusting for these patients, the survival findings were similar. 43 patients (31%) received a platinum containing ASR. In the platinum subgroup, ASRs were associated with longer EFS and DFS compared to ABRs, but this effect was not statistically significant in the node-positive group. No cardiac or secondary leukemic events were observed in either group. Conclusions: ABRs were associated with shorter EFS, DFS and OS, even after adjusting for certain high-risk clinical features. Larger studies are needed to identify the role of platinum containing ASRs in patients with early TNBC.

Levosimendan in patients with low cardiac output syndrome undergoing cardiac surgery: A systematic review and meta-analysis

Levosimendan is an inotropic agent that has been shown in small studies to treat low cardiac output syndrome in cardiac surgery. However, large randomised controlled trials (RCTs) have been recently published and presented neutral results. We sought to determine the effect of levosimendan on mortality in adults with low ejection fraction undergoing cardiac surgery. We searched different databases: Medline, Embase, Cochrane Central Register of Controlled Trials, and clinical trial registries. We included RCTs comparing events in the levosimendan versus placebo in adult patients with ejection fraction ≤ 35% undergoing cardiac surgery. Outcomes were mortality at 30-day, mortality beyond 30−day, acute kidney injury and myocardial infarction. Five trials with a total of 1519 patients were selected. Four trials were rated as low risk of bias. Our meta-analysis showed no significant difference between levosimendan versus placebo mortality at 30-day [odds radio (OR): 0.62; 95% confidence intervals (CI): 0.32 to 1.20; I2 = 33%; high quality evidence] and mortality beyond 30-day (OR: 0.71; 95% CI: 0.46 to 1.11; I2 = 0%). Similarly, there were no significant differences between the levosimendan versus placebo in the incidence of acute kidney injury (OR: 0.61, 95% CI: 0.33−1.13) and myocardial infarction (OR: 0.41, 95% CI: 0.08 to 1.22). The current evidence suggests that levosimendan is not associated with significantly reduced mortality in patients with reduced ejection fraction undergoing cardiac surgery.

The role of bladder volume in the success of external cephalic version

ObjectiveNumerous studies have evaluated the factors associated with ECV success. Yet, bladder volume has never been examined. We hypothesize that maternal bladder volume may affect ECV success rate. We aim to evaluate the role of maternal bladder volume during external cephalic version (ECV) on the procedure success rates. Study designWe reviewed prospective collected data of all patients who underwent ECV at our center during 2001–2012. The study group included 100 patients that underwent ECV with bladder volume below 400 ml. These patients were matched to 400 patients that underwent ECV with bladder volume equal or above 400 ml which composed the control group. Maternal and fetal characteristics and outcomes were compared. ResultsECV was successfully performed in 80/100 (80.0%) of patients in the study group as compared to 257/400 (64.3%) in the control group (P = 0.002). Factors associated with ECV success were older age (P = 0.003), having prior delivery (P < 0.0001), higher amniotic fluid index (AFI) (P = 0.001) and placenta located in the posterior wall (P = 0.001).In a logistic regression analysis, bladder volume was found to be an independent predictor of ECV success Odds radio (OR) for ECV success 2.5 (CI 1.42–4.34). Posterior placenta and higher AFI were found to be an independent predictors of ECV success as well; OR 2.7 (CI 1.74–4.34) and OR 1.07 (CI 1.02–1.13) respectively. ConclusionECV is more successful in patient with bladder volume below 400 ml. Amniotic fluid volume and placental location were found as independent predictors of ECV outcome as well.

Clinicopathological and prognostic value of lncRNA PANDAR expression in solid tumors: Evidence from a systematic review and meta‐analysis

PANDAR (promoter of CDKN1A antisense DNA damage activated RNA) has been shown to be aberrantly expressed in many types of cancer. Considering conflicting data, the current study was aimed to assess its potential role as a prognostic marker in malignant tumors. A comprehensive literature search of PubMed, Medline, and Web of Science was performed to identify all eligible studies describing the use of PANDAR as a prognostic factor for different types of cancer. Data related to overall survival (OS) and clinicopathologic features were collected and analyzed. The pooled hazard ratio (HR) and odds radio (OR) with a 95% confidence interval (CI) were used to estimate associations. Ten original studies containing 1,231 patients were included. The results showed that in patients with cancer, high PANDAR expression is correlated with lymph node metastasis (LNM; OR = 2.57; 95% CI, 1.76-3.81; p < 0.001), tumor stage (OR = 2.90; 95% CI, 1.25-6.75; p = 0.013), and tumor size (OR = 1.79; 95% CI, 1.11-2.91; p = 0.018). However, sensitivity analysis further demonstrated a significant association between high PANDAR expression and OS, both in multivariate and univariate analysis models (pooled HR 2.01; 95% CI, 1.17-3.44 and pooled HR 2.62; 95% CI, 1.98-3.47, respectively), after omitting one study. These results suggested that PANDAR expression might be indicative of advanced disease and poor prognosis in patients with cancer. Further studies are necessary to determine the value of this risk stratification biomarker in clinical management of patients with cancer.

A meta-analysis of the relationship between environmental tobacco smoke and lung cancer risk of nonsmoker in China.

Background:To investigate the association between exposure to environmental tobacco smoke (EVT) and the incidence of lung cancer (LC) in nonsmoking adults.Method:PubMed, Cochrane, Embase, Wanfang, CNKI, and VIP database were searched by the index words to identify the qualified case-control studies, and relevant literature sources were also searched. The latest research was done in June 2017. Odds radio (OR) along with 95% confidence interval (95% CI) were used to analyze the main outcomes.Result:Twenty RCTs were involved in the meta-analysis with 13,004 adults in the case group and 11,199 adults in the control group. The results indicated that compared with the nonexposure population, the risk of LC incidence was significantly higher in EVT exposure (OR: 1.64, 95% CI: 1.34–2.01), EVT male exposure (OR: 1.62, 95% CI: 1.16–2.28), EVT female exposure (OR: 1.57, 95% CI: 1.43–1.72), EVT exposure at workplace (OR: 1.78, 95% CI: 1.29–2.44), EVT exposure at home (OR: 1.53, 95% CI: 1.01–2.33), and EVT female exposure at home (OR: 1.55, 95% CI: 1.34–1.79). However, there is still no significant difference among the risk of LC incidence in EVT male exposure at workplace (OR: 1.51, 95% CI: 0.74–3.06), EVT female exposure at workplace (OR: 1.23, 95% CI: 0.99–1.53), and EVT male exposure at home (OR: 1.24, 95% CI: 0.68–2.26).Conclusion:EVT exposure is prospectively associated with a significantly increased risk of LC incidence. More high quality studies are required to address the association between EVT exposure and LC incidence.

Association between maternal body mass index and congenital heart defects in infants: A meta-analysis

We conducted this meta-analysis to address the open question of a possible association between maternal body mass index (BMI) and congenital heart defects (CHDs) in infants. We conducted a comprehensive computerized search of PubMed, Web of Science, Medline, and Embase databased (January 1980 through August 2017). We assessed the association between maternal BMI and the risk for congenital heart defects in their offspring. Study-specific relative risk estimates were polled according to random-effect or fixed-effect models. From 2567 citations, a total of 13 case-control studies and 4 cohort studies were selected for a meta-analysis, including more than 1150000 cases. The pooled odds radio (OR) of 1.065 (95% confidence interval [CI], 1.021-1.100; P = .001; I2 = 60.1%) indicated a positive effect of maternal overweight status (BMI 25.0-29.9 kg/m2 ) on the risk for congenital heart defects in infants. Moreover, we observed a significant association between maternal obesity (BMI ≥ 30 kg/m2 ) and congenital heart defects in their offspring (OR: 1.174; 95% CI, 1.146-1.203, P = 0.161; I2 =25.5%). However, there was little significant evidence of an association between maternal underweight status (BMI < 18.5 kg/m2 ) and offspring with congenital heart defects, and the pooled OR was 1.015 (95% CI, 0.980-1.052; P = 0.085; I2 =34.0%). Our meta-analysis provides robust evidence of the positive association between maternal BMI and the risk for fetal congenital heart defects.

Chinese Medicinal Herbs in the Treatment of Diabetic Cognitive Impairment: A Systematic Review and Meta-Analysis.

Background Diabetic cognitive impairment (DCI), a serious complication of diabetes mellitus (DM), is gaining more acceptance and attention. The learning and memory function of diabetics always decreases. Traditional Chinese medicine (TCM) has been demonstrated to be effective in treating the symptoms in China, and thereinto Chinese medicinal herbs (CMH) are the most widely used. The objective of the present study was to review and analyze the existing data about reducing the symptoms in CMH treatment for DCI. Methods Electronic literature databases (PubMed, EMBASE, CNKI, SinoMed, and Wan fang) were searched for randomized controlled trials conducted in China, comparing CMH with western medicines in the treatment of DCI, up to April 1, 2018. We applied standard meta-analytic techniques to analyze data from papers that reached acceptable criteria. Result Nine randomized controlled trials (n = 576) on CMH were included. We found moderate evidence that CMH used alone or in combination with western medicines was more effective than western medicines alone in reliving the symptoms for DCI (total effective rate, odds radio (OR) = 4.64 (2.60, 8.29), and 95% confidence interval, P<0.00001). Besides, CMH along or in combination with western medicines showed more beneficial effects on Montreal Cognitive Assessment (MoCA) scale (mean difference (MD) = 1.31(0.75, 1.87), P<0.00001), Mini-Mental State Examination (MMSE) scale (MD = 2.07 (0.86, 3.28), P<0.00001, and TCM symptom score (TCMSS) (MD = -4.89 (-8.44, -1.34), P = 0.007). Most of the included studies showed that there was not a significant difference in the adverse events. Conclusions These findings demonstrated that CMH used alone or in combination with western medicines were apparently better than western medicines alone in the treatment of DCI. Because of the poor quality of the studies that were available for the present meta-analysis, further researches are still needed to support these early findings.

Association between oxidized low‐density lipoprotein and cognitive impairment in patients with ischemic stroke

The association between oxidized low-density lipoprotein (oxLDL) and cognitive impairment is unclear. This study aimed to investigate the potential association between oxLDL and cognitive impairment among patients with acute ischemic stroke. We measured the levels of oxLDL and recorded the Mini-Mental State Examination (MMSE) score in patients with acute ischemic stroke who were recruited from the Study of Oxidative Stress in Patients with Acute Ischemic Stroke. Cognitive impairment was defined as an MMSE score of <24. The association between oxLDL and cognitive impairment was assessed by multivariate logistic or linear regression analysis. Other clinical variables of interest were also studied. A total of 3726 patients [1287 (34.54%) female] were included in this study, with a mean age of 63.62±11.96years. After adjusting for potential confounders in our logistic regression model, each SD increase in oxLDL was associated with a 26% increase in the prevalence of cognitive impairment (odds radio, 1.26; 95% confidence interval, 1.13-1.39; P<0.0001). Similarly, higher oxLDL was associated with lower MMSE scores, with a 0.56-point decrease in MMSE score for every SD increase in oxLDL in a linear regression analysis (β=-0.56; 95% confidence interval, -0.81 to -0.32; P<0.0001). There were no significant interactions between oxLDL and age, sex or education levels for cognitive impairment (all interactions, P>0.05). Elevated levels of oxLDL were associated with a higher prevalence of cognitive impairment in patients with ischemic stroke.

Association of polymorphisms in heat shock protein 70 genes with the susceptibility to noise-induced hearing loss: A meta-analysis.

BackgroundSeveral case-control studies reported the relationship between single nucleotide polymorphisms (SNPs) in HSP70 genes and noise-induced hearing loss (NIHL). However, their conclusions are conflicting. This meta-analysis aims to identify the association of HSP70 variants and NIHL susceptibility.MethodA systematical literature search was performed in PubMed, Web of Science, EMBASE, and Wanfang Chinese database. The pooled odds radio (OR), 95% confidence interval (CI) and p value were calculated in fixed- or random-effects model according to the I2 value in the heterogeneity test.ResultsFour articles containing five studies, including 633 cases and 926 controls, were included. Under the allele, homozygote and dominant model, the pooled ORs (95%CI, p-value) of rs1061581 were 1.32 (1.06–1.67, p = 0.019), 1.93 (1.10–3.36, p = 0.021) and 1.455 (1.408–2.019, p = 0.025), respectively. In addition, a significant association was found between rs2227956 in Caucasians and the NIHL susceptibility under all five genetic models. We did not discover evidence sufficient to prove the associations between the other three SNPs (rs1043618, rs2763979 and rs2075800) and the NIHL susceptibility.ConclusionThis meta-analysis indicated that the two HSP70 variants, rs1061581 and rs2227956, may serve as genetic susceptibility factors for NIHL. Larger scale studies are required to further update the results.

Prognostic and clinicopathological value of Twist expression in breast cancer: A meta-analysis.

BackgroundDespite initial indications that the transcription factor Twist could be used as a breast cancer prognostic marker, there still exists some controversy about its reliability. Thus, the aim of the present study was to assess the relationship between Twist expression and prognosis in breast carcinoma.Materials and methodsWe identified eligible studies that reported an association between Twist expression and breast cancer prognosis by searching the literature in PubMed, Embase, the Cochrane Library, and Web of Science databases, through June 5, 2017. Studies investigating Twist protein or mRNA expression as well as reporting survival data in breast cancer were included. The pooled hazard ratio (HR) and odds radio (OR) with a 95% confidence interval (95% CI) were used to estimate associations.ResultsA total of 2,671 patients from seven included studies were assessed, and the data indicated that increased Twist expression significantly correlated with poor overall survival (OS) (HR, 1.15; 95% CI, 1.00–1.33; P = 0.04) in breast cancer. In addition, we also observed a significant correlation of elevated Twist expression with larger tumor size (OR, 1.92; 95% CI, 1.31–2.81; P = 0.0009), lymph node involvement (OR, 3.81; 95% CI, 1.16–12.54; P = 0.03), higher nuclear grade (OR, 1.45; 95% CI, 1.06–2.00; P = 0.02), and positive human epidermal growth factor receptor 2 (HER2) status (OR, 1.49; 95% CI, 1.06–2.09; P = 0.02). However, no correlation between Twist expression and disease-free survival (DFS), age, estrogen receptor (ER) status, and progesterone receptor (PR) status was observed.ConclusionsOur results demonstrate that Twist over-expression is a statistically significant indicator of OS in breast cancer. In addition, our meta-analysis shows that increased Twist expression is significantly associated with larger tumor size, lymph node involvement, higher nuclear grade, and positive HER2 status.

Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India.

Acute Kidney Injury (AKI) is a serious condition in neonatal care. It complicates the management necessitating the restrictive use of medications. To evaluate clinical profile, identify associated and prog-nostic factors in newborns with AKI. This was a case control study done between January 2008 to January 2010. Total 1745 newborns were admitted, of which 74 babies had AKI. It was defined as serum creatinine >1.5mg/dl. Control group was selected randomly from the hospital numbers of the newborns derived from the electronic registry with serum creatinine below 1.5 mg/dl. Demographic variables like birth weight, gender, gestational age, admission age, growth restriction, Apgar scores, electrolyte levels; and common clinical conditions like asphyxia, sepsis, meningitis, persistent pulmonary hypertension, Necrotizing Enterocolitis (NEC), mechanical ventilation, congenital heart disease; were compared amongst the two groups. Information was obtained from the admission register, admission files, labor register of obstetrics and gynaecology department and electronic registry. Chi square/independent sample t-test as applicable and logistic regression were used to establish an association of various factors and outcome with AKI. The incidence of AKI in our study was 4.24%. Demographic variables more common in AKI group were inborn (p=0.011), male gender (p=0.032), term gestation (p=0.001), Appropriate for gestational age (0.001), higher birth weight (p<0.001), full term (p<0.001), sepsis (p<0.001), NEC (p=0.042), low ApGAR scores at one minute (p=0.011) and five minute (p=0.003). However, on multivariate logistic regression only male gender [Odds Radio (OR)=2.84, Confidence Interval (CI)=1.12-7.21] and Sepsis (OR=14.46, CI=4.5-46.46) were associated with AKI. Respiratory distress syndrome was more prevalent in the control group (p<0.003). No need of mechanical ventilation and absence of shock, improved the survival. AKI continues to be of clinical significance in neonatal intensive care. Further studies are needed to evaluate newer associations (like male gender and low APGAR scores).

Prevalence of dyspeptic symptoms among patients on low-dose antiplatelet therapy

Background: Low-dose antiplatelet therapy is the standard of care for the prevention of primary and secondary cardiovascular events. Dyspeptic symptoms may result in discontinuation of treatment. Aim: The aim of the study was to determine the prevalence of dyspeptic symptoms among patients on low-dose antiplatelet therapy for primary and secondary prevention of cardiovascular events. Subjects, Materials, and Methods: This was a cross-sectional descriptive study of 253 adults on low-dose antiplatelet attending the Cardiology Clinic of the University of Calabar Teaching Hospital. Prevalence and clinical impact of dyspepsia were assessed using a structured questionnaire incorporating the gastrointestinal symptom rating scale. Data were analyzed using the Statistical Package for Social Sciences version 20. Results: A total of 253 patients were recruited for this study. The mean age was 54 ± 12.2 years. The prevalence of dyspeptic symptoms was 47.8%. Epigastric pain was the most common self-reported dyspeptic symptom (33.2%) followed by heartburn (23.7%). Melena and hematemesis were reported by 5.5% and 1.2% of the patients. Treatment duration was longer for those with dyspeptic symptoms (45.8 ± 139.6 vs. 28.3 ± 31 months), but the difference was not statistically significant (P = 0.17). A prior history of peptic ulcer disease was predictive of dyspeptic symptoms (odds radio; 8.62, confidence interval; 2.49–29.83). Majority (71.7%) of the patients reported their symptoms as occasional episodes which mildly impair their daily quality of life. Compliance was impacted in 6.7% of the patients. Conclusion: Dyspeptic symptoms, mostly epigastric pain, are prevalent among Nigerian patients on low-dose antiplatelets which negatively impact their daily life activities and compliance to treatment.

Relationship between NR1I2 polymorphisms and inflammatory bowel disease risk: A systematic review and meta-analysis

Inconsistent results regarding an association between polymorphisms within the Homo sapiens nuclear receptor subfamily 1 group I member 2 (NR1I2) gene and susceptibility to inflammatory bowel disease (IBD) have been reported. A systematic review and meta-analysis was thus undertaken to determine whether NR1I2 gene polymorphisms are associated with an increased risk of IBD. Article retrieval was performed using on-line databases, such as PubMed, Embase, CENTRAL, and WOS. After extracting eligible data, Mantel-Haenszel statistics were applied to calculate the odds radio (OR), 95% confidence interval (95% CI) and P value under a random or fixed-effects model. A total of seven articles with 4410 IBD subjects and 4028 controls were included. Compared with the control group, no significant increase in IBD susceptibility was observed for the -25385C/T (OR=0.92, 95% CI=0.78∼1.07, P=0.259), -24381A/C (OR=0.96, 95% CI=0.87∼1.06, P=0.378), +8055C/T (OR=1.06, 95% CI=0.97∼1.15, P=0.186), or +7635A/G (OR=0.96, 95% CI=0.87∼1.05, P=0.348) polymorphisms within the NR1I2 gene under the allele model. Our meta-analysis failed to demonstrate an association between -25385C/T, -24381A/C, +8055C/T, or +7635A/G polymorphisms within the NR1I2 gene and overall IBD risk. A larger sample size is needed to validate our conclusion.