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Πέμπτη 26 Ιανουαρίου 2023

The association among insomnia symptom severity, comorbid symptoms, and suicidal ideation in two veteran cohorts meeting diagnostic criteria for insomnia disorder

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Abstract

Objective

Examine the association between insomnia symptom severity and suicidal ideation (SI), after adjusting for clinical comorbidity in veterans meeting diagnostic criteria for insomnia disorder.

Methods

Secondary data analyses of psychometrically validated baseline assessments of depression, posttraumatic stress disorder (PTSD), and anxiety symptoms from two online insomnia intervention randomized clinical trials (n = 232; n = 80) were conducted. Multiple linear regression was used to determine the association between insomnia symptom severity and SI, after controlling for clinical comorbidity and demographics.

Results

Insomnia symptom severity was significantly correlated with comorbid depression, PTSD, and anxiety symptoms in both cohorts and significantly correlated with SI in one. After controlling for demographics and clinical comorbidity, insomnia symptom severity was not significantly associated with SI in linear regression models.

Conclusion

Findings extend insomnia-suicide research by providing evidence that insomnia symptom severity may not confer a unique risk for SI above comorbid mental health symptoms in veterans meeting diagnostic criteria for insomnia disorder.

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Analgesic Effectiveness of Preoperative Ultrasound‐Guided Erector Spinae Plane Block versus Paravertebral Nerve Block for Breast Surgery: A Systematic Review and Meta Analysis of Four Randomized Controlled Trials

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

Our meta-analysis aimed to compare the analgesic effectiveness of ultrasound-guided preoperative erector spinae plane block (ESPB) versus paravertebral nerve block (PVB) in breast surgery.

Methods

PubMed, EMBASE and the Cochrane Library were searched for randomized controlled trials (RCTs) between January 1, 1980 and April 31, 2021 . The primary endpoints were perioperative pain score, analgesic consumption and assessment of block procedure. The secondary endpoints were intraoperative haemodynamic response, duration of surgery, postoperative antiemetic consumption and adverse effects.

Results

Four RCTs comprised of a total of 310 patients were included in our meta-analysis. No significant differences in the perioperative pain score and analgesic consumption were observed between ESPB and PVB in the operating room, post-anaesthesia care unit (PACU) and ward (at 1, 16, 12, and 24 hour, and the morning of postoperative day 1 (POD1) (all P > 0.05). Similarly, no significant differences in the duration of block, time to first analgesic, haemodynamic response, duration of surgery, postoperative antiemetic consumption and adverse effects were observed (all P > 0.05). However, our meta-analysis revealed that ultrasound-guided preoperative ESPB significantly reduced the duration of procedure time and frequency of guidance interventions, as well as increasing the block success rate among residents (all P < 0.05).

Conclusions

Both ultrasound-guided preoperative ESPB and PVB showed comparable analgesic effects in patients undergoing breast surgery. However, with a significantly shorter procedure time and higher block success rate, our findings suggest that ESPB may be a simple alternative to PVB in breast surgery.

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Association between inflammatory bowel disease and periodontitis: A bidirectional 2‐Sample Mendelian randomization study

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Abstract

Aim

This Mendelian randomization (MR) study was performed to explore the potential bidirectional causal association between inflammatory bowel disease (IBD) and periodontitis.

Materials and methods

We used genetic instruments from the genome-wide association study (GWAS) summary statistics of European descent for IBD (12,882 cases, 21,770 controls) to investigate the association with periodontitis (3,046 cases, 195,395 controls) and vice versa. The radial inverse-variance weighted (IVW) method was carried out to obtain the primary causal estimates, and the robustness of the results was assessed by a series of sensitivity analyses. Due to multiple testing, associations with P values < 0.008 were considered as statistically significant, and P values ≥ 0.008 and < 0.05 were considered as suggestively significant.

Results

In the primary causal estimates, IBD as a whole was associated with an increased risk of periodontitis (odds ratio [OR], 1.060; 95% confidence interval [CI], 1.017; 1.105; P = 0.006). Subtype analyses showed that ulcerative colitis (UC) was associated with periodontitis (OR, 1.074; 95% CI 1.029; 1.122; P=0.001), while Crohn's disease (CD) was not. Regarding the reverse direction, periodontitis showed a suggestive association with IBD as a whole (OR, 1.065; 95% CI 1.013; 1.119; P=0.014). Subtype analyses revealed that periodontitis was associated with CD (OR, 1.100; 95% CI 1.038; 1.167; P=0.001) but not UC. The final models after outlier removal showed no obvious pleiotropy, indicating that our primary analysis results were reliable.

Conclusions

The present MR study provides moderate evidence on the bidirectional causal relationship between IBD and periodontitis. The bidirectional increased risk found in our study was marginal and, possibly, of limited clinical relevance. More studies are needed to support the findings of our current study.

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Inhibition of PIKFYVE kinase interferes ESCRT pathway to suppress RNA virus replication

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Abstract

ESCRT (Endosomal sorting complex required for transport) is essential in the functional operation of endosomal transport in envelopment and budding of enveloped RNA viruses. However, in non-enveloped RNA viruses such as enteroviruses of the Picornaviridae family, the precise function of ESCRT pathway in viral replication remains elusive. Here, we initially evaluated that ESCRT pathway is important for viral replication upon EV71 (Enterovirus 71) infection. Furthermore, we discovered that YM201636, a specific inhibitor of PIKFYVE (Phosphoinositide kinase, FYVE finger containing) kinase, significantly suppressed EV71 replication and virus-induced inflammation in vitro and in vivo. Mechanistically, YM201636 inhibits PIKFYVE kinase to block ESCRT pathway and endosomal transport, leading to the disruption of viral entry and replication complex in subcellular components and ultimately repression of intracellular RNA virus replication and virus-induced inflammatory responses. Furt her studies found that YM201636 broadly represses the replication of other RNA viruses, including CVB3 (Coxsackievirus B3), PV1 (Poliovirus 1), E11 (Echovirus 11), ZIKV (Zika virus), and VSV (Vesicular stomatitis virus), rather than DNA viruses, including ADV3 (Adenovirus 3) and HBV (Hepatitis B virus). Our findings shed light on the mechanism underlying PIKFYVE-modulated ESCRT pathway involved in RNA virus replication, and also provide a prospective antiviral therapy during RNA viruses infections.

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Molecular characterization of rotavirus infections in children less than 5 years of age with acute gastroenteritis in Tehran, Iran, 2021 to 2022: Emergence of uncommon G9P[4] and G9P[8] rotavirus strains

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Abstract

The present study was conducted to monitor the genotypes of circulating species A rotavirus (RVA) in Iran and investigate genetic linkages between specific RVA VP7, VP4, VP6, and NSP4 segments. For this purpose, 48 RVA strains were detected during the 2021-2022 seasons. The two combinations of G9P[4] and G9P[8] RVA strains were predominant. However, several other combinations of RVA also were detected. Based on the distribution of I and E genotypes (46 strains) with respect to G and P, the most common strains were G9P[4]-I2-E2 (19.5%), G9P[4]-I2-E1 (6.5%), G9P[4]-I1-E1 (4.3%), G9P[8]-I1-E1 (19.5%), and G9P[8]-I2-E2 (10.9%), which were followed by several other combinations of G and P RVA strains with different pattern of I-E genotypes and also emerging, rare and uncommon strains. The present study described the continued circulation of G9 strains with the emergence of uncommon G9P[4] and G9P[8] reassortants with three and two different I-E genotypes, respect ively, which have not been reported previously in Iran. Our findings indicated that these uncommon strains exhibited a unique genotype pattern comprising a mixture of genogroup 1 and 2 genes and suggest the need for further analysis of rare, uncommon, and emerging strains of RVA at all 11 gene segments to determine intergenogroup and intragenotype reassortments.

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Prevalence of cervical human papillomavirus and the risk of anal co‐infection in kidney transplant recipients: Results from a Danish clinical study

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Abstract

Background

: Kidney transplant recipients (KTRs) have increased risk of human papillomavirus (HPV)-related cancers, including cervical and anal cancer. In this cross-sectional clinical study, we investigated the prevalence of cervical high-risk HPV (hrHPV) and low-risk (lrHPV), risk factors for cervical hrHPV infection, and the prevalence of cervical and anal hrHPV co-infection in KTRs and immunocompetent controls.

Methods

: During 2016–2017, we recruited 125 female KTRs and 125 female immunocompetent controls from one dermatology department (KTRs and controls) and five nephrology departments (KTRs) in Denmark. Liquid-based cervical and anal cytology samples were tested for HPV DNA using the INNO-LiPA test and participants answered a questionnaire on lifestyle. Odds ratios (ORs) were estimated using logistic regression, adjusting for age, lifetime sexual partners, smoking, and (in models concerning anal HPV) receptive anal sex.

Results

: KTRs had higher prevalence of cervical hrHPV than controls (35.5% vs 18.2; ORadjusted = 2.9, 95% CI, 1.5–5.5). In contrast, the prevalence of lrHPV was similar in KTRs and controls (25.6% vs 23.1; ORadjusted = 1.2, 95% CI, 0.7‒2.3). KTRs were more likely than controls to have cervical and anal hrHPV co-infection (27.3% vs. 6.6%, ORadjusted = 6.3, 95% CI, 2.7–15.0).

Conclusions

: Female KTRs had high prevalence of cervical hrHPV, and co-infection with anal and cervical hrHPV was common. Our results underline that KTRs are an important target group for preventive efforts against HPV-related diseases.

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