Cold weather increases the risk of scrotal torsion events: results of an ecological study of acute scrotal pain in Scotland over 25 years

Abstract The role of ambient temperature in the aetiology of acute scrotal pain (ASP) remains uncertain. The most common causes of ASP are torsion of the testis (TT) or its appendages (TA) and epidymo-orchitis (EO). We undertook an ecological study of ASP in Scotland to determine whether a seasonal variation could be observed. Episode reports for TT, TA and EO in Scotland over 25 years were collated monthly. Statistical analyses were performed to determine whether changes in ambient temperature during the year could explain variations in monthly frequency. 7882 episodes of TT and TA (Group A), and 25,973 episodes of EO (Group B) were reported. There was significant variance in the frequency of Group A (p < 0.0001) and B (p = 0.0031) episodes by month, higher frequency of Group A episodes in the colder half of the year (p < 0.0001), and an inverse correlation between the frequency of Group A episodes and ambient temperature (Spearman r = − 0.8757, 95% CI − 0.9661 to − 0.5941, p = 0.0004). Ambient temperature is likely to be playing a role in the aetiology of TT and TA in Scotland but not EO. Further study is warranted to explain underlying mechanisms.

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Effect of gestational age and postnatal age on the endothelial glycocalyx in neonates

Scientific Reports ◽

10.1038/s41598-021-81847-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alexandra Puchwein-Schwepcke ◽

Stefanie Artmann ◽

Lea Rajwich ◽

Orsolya Genzel-Boroviczény ◽

Claudia Nussbaum

Keyword(s):

Gestational Age ◽

Boundary Region ◽

Vascular Pathology ◽

Endothelial Glycocalyx ◽

Preterm Neonates ◽

Extrinsic Factors ◽

Term Neonates ◽

Group A ◽

Underlying Mechanisms ◽

Group B

AbstractPrematurity predisposes to cardiovascular disease; however the underlying mechanisms remain elusive. Disturbance of the endothelial glycocalyx (EG), an important regulator of vessel function, is thought to contribute to vascular pathology. Here, we studied the EG with respect to gestational and postnatal age in preterm and term neonates. The Perfused Boundary Region (PBR), an inverse measure of glycocalyx thickness, was measured postnatally in 85 term and 39 preterm neonates. Preterm neonates were further analyzed in two subgroups i.e., neonates born < 30 weeks gestational age (group A) and neonates born ≥ 30 weeks (group B). In preterm neonates, weekly follow-up measurements were performed if possible. PBR differed significantly between preterm and term neonates with lowest values representing largest EG dimension in extremely premature infants possibly reflecting its importance in fetal vascular development. Linear regression revealed a dependence of PBR on both, gestational age and postnatal age. Furthermore, hematocrit predicted longitudinal PBR changes. PBR measured in group A at a corrected age of > 30 weeks was significantly higher than in group B at birth, pointing towards an alteration of intrinsic maturational effects by extrinsic factors. These changes might contribute to the increased cardiovascular risk associated with extreme prematurity.

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A comparative study to evaluate pregnancy related issues among women aged 35 years old and beyond

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20220014 ◽

2022 ◽

Author(s):

Heena Mir ◽

Neha Mahajan

Keyword(s):

Maternal Age ◽

Pregnancy Loss ◽

Negative Impact ◽

Early Pregnancy Loss ◽

Younger Women ◽

Medical College ◽

Significant Difference ◽

Group A ◽

Underlying Mechanisms ◽

Group B

Background: The pregnancy complications associated with women over 35 years of age are becoming more frequent. Late or too late remains the thread bearing discussion these days. Multiple studies have reported that women with 35 years of age or beyond are more vulnerable to develop obstetric complications. The present study has been conducted to reckon the strength of the association between maternal age and obstetric issues pertaining to women.Methods: This prospective study considered 217 single consecutive pregnancies which were divided into two groups based on age of patients. Group A consists of 163 pregnant women aged < 35 years and group B consists of 54 pregnant patients aged ≥35 years. The study was conducted at government medical college, Lala-Ded, and hospital Srinagar.Results: In spite of the underlying mechanisms, rigorous statistical analysis revealed the negative impact of extreme maternal ages on pregnancy. We found a significant difference between group A and group B with respect to early pregnancy loss, C-section, antepartum, intrapartum and postpartum complications (p<0.001).Conclusions: Evidently, it was demonstrated that women aging 35 years or above are more vulnerable to develop multiple intrapartum and postpartum complications than younger women in group B.

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A comparative study of graft uptake in split skin grafting between the first postoperative dressing done on day 3 versus day 5

International Surgery Journal ◽

10.18203/2349-2902.isj20214754 ◽

2021 ◽

Vol 8 (12) ◽

pp. 3615

Author(s):

Gurushantappa Yalagachin ◽

Abhijit D. Hiregoudar ◽

Sanjay B. Mashal ◽

Ashika Bagur ◽

Naveena G. Shivaramu

Keyword(s):

Skin Grafting ◽

Rejection Rate ◽

Split Skin Grafting ◽

Common Causes ◽

Group A ◽

The Common ◽

The Mean ◽

Group B ◽

Split Skin ◽

Comparative Prospective Study

Background: Skin grafting offers a method of regaining skin continuity. The common causes of skin graft failure are hematoma, seroma, infection. These affect the graft uptake maximally in the initial postoperative period by impairing graft adherence and subsequent revascularization. Aim of study was to compare graft uptake, rejection, seroma and infection among first postoperative dressing on day 3 versus day 5.Methods: A comparative, prospective study conducted at our institute from November 2015 to April 2021, with 100 patients who underwent SSG (split skin grafting) who were distributed into two groups. Group A underwent the first postoperative dressing on day 3 and group B on day 5. The second postoperative dressing was done 2 days following the first. The grafted site was then assessed on for the percentage of graft uptake, rejection, seroma, infection clinically and through culture and sensitivity.Results: The mean graft uptake in group A was 88.48% whereas in group B was 82.62% in the first dressing and in the second dressing, group A was 88.14% whereas group B was 78.02%, with statistically significant data and thus showing less rejection and infection rate in group A. Seroma was present in 82% of cases in group A and 74% in group B on 1st postoperative dressing which reduced to 6% and 12% respectively with the 2nd dressing.Conclusions: Thus, the first postoperative dressing done on Day 3 following skin grafting, significantly increased the final uptake of the graft, reduced seroma, infection and rejection rate.

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Oxidative stress and anabolic hormones in back pain: Current concept and preliminary analysis in male cohort

Orthopedic Reviews ◽

10.4081/or.2020.8686 ◽

2020 ◽

Author(s):

Edoardo Vergani ◽

Carmine Bruno ◽

Andrea Silvestrini ◽

Elisabetta Meucci ◽

Luca Proietti ◽

...

Keyword(s):

Oxidative Stress ◽

Back Pain ◽

Inverse Correlation ◽

Medical Problem ◽

Significant Inverse Correlation ◽

Anabolic Hormones ◽

Total Antioxidant ◽

Male Cohort ◽

Group A ◽

Group B

Back Pain (BP) is a common medical problem; anabolic hormones, through the modulation of oxidative stress (OS), could influence fracture risk. We evaluated the prevalence of anabolic hormonal deficiencies and their relationship with OS in males with BP, associated or not to nontraumatic fractures. 49 males with BP, from 36 to 80 years, were divided in two groups according to radiological evidence of nontraumatic fractures; group A (n=25): non-fractured; group B (n=24): fractured. A different prevalence of hormonal deficits was observed: 24% of hypotestosteronemia in A, 0% in B; 16% of GHD in A, 29% in B; Total Antioxidant Capacity (TAC) showed a trend toward higher levels in B. In A, despite lower TAC, a significant inverse correlation was present between TAC and IGF-1. A greater prevalence of GHD in patients with vertebral fractures was seen and, in a subgroup, OS could mediate the deleterious effects of hyposecretory GH state.

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Correlation of vitamin D level with its related biochemical parameters and impact of different treatment regimens on their correction

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20205511 ◽

2020 ◽

Vol 8 (1) ◽

pp. 86

Author(s):

Amit Gupta ◽

Sachin Kumar

Keyword(s):

Biochemical Parameters ◽

Inverse Correlation ◽

Ultraviolet Rays ◽

P Value ◽

Significant Inverse Correlation ◽

Treatment Groups ◽

Treatment Regimens ◽

Before And After ◽

Group A ◽

Group B

Background: Vit D is a fat-soluble vitamin that is produced when ultraviolet rays from sunlight strike the skin and trigger vit D synthesis. Aims and Objectives of the study were to find out the correlation of vit D level with its related biochemical parameters and impact of two different treatment regimens on their correction. Methods: A total of 107 patients were followed up out of which 89 were vit D deficient and rest were vit D insufficient. Results: Mean age of the patients was 6.11±4.49 and males comprised 66%. Mean BMI of children included in group A, B and C was 19.40±2.69, 19.60±3.18 and 20.95±3.72 kg/m2 respectively. Vit D levels at baseline had a significant inverse correlation with ALP (r=-0.27, p value=0.008). Before and after comparison of mean serum calcium levels revealed significant improvement in both the treatment groups. Severity of vit D deficiency, at baseline, 9.10, 77.30 and 13.60% of patients had vit D levels of less than 5, 5 to 15 and more than 15 for group A respectively. In group B at baseline, 6.70, 71.10 and 22.20% of patients had vit D levels of less than 5, 5 to 15 and more than 15 respectively.Conclusions: Present study found that 60,000 IU/week and dose of 2000 IU/day for infants or 5000 IU/day for 1 to 18 years of age, along with 500 to 800 mg oral calcium for 6 to 8 weeks can result in correction of vit D deficiency.

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A comparative analysis of morphometric changes in the angle of anterior chamber after cataract surgery

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213073 ◽

2021 ◽

Vol 9 (8) ◽

pp. 2296

Author(s):

Mahsa Jamil ◽

Anupam . ◽

Ramanuj Samanta ◽

Sanjeev Kumar Mittal

Keyword(s):

Cataract Surgery ◽

Anterior Chamber ◽

Anterior Chamber Depth ◽

Cataract Extraction ◽

Anterior Chamber Angle ◽

Small Incision Cataract Surgery ◽

Common Causes ◽

Quasi Experimental ◽

Group A ◽

Group B

Background: Cataract surgery brings about certain changes in the angle of anterior chamber and we aimed at understanding the morphometric changes occurring in the angle at the site of incision (SOI) and the site opposite to it (OSOI) after two types of cataract surgeries viz. phacoemulsification and manual small incision cataract surgery (SICS) at two postoperative follow-ups.Methods: A quasi-experimental study was conducted at AIIMS, Rishikesh and a minimum of 60 patients were enrolled. They were divided into two groups based on the surgery performed, 30 patients had undergone phacoemulsification (group A) and 30 patients had undergone SICS (group B). The patients were evaluated using optical coherence tomography (OCT), the parameters measured were central anterior chamber depth (ACD), anterior chamber angle (ACA), angle opening distance (AOD), and trabecular iris surface area (TISA). The subjects were assessed preoperatively, post-operatively at 1 week and 6 weeks.Results: The increase in the angle parameters at 1 week and 6 weeks post-operatively was found to be statistically significant in the two groups (p<0.05). The increase in the parameters was also compared between the two surgeries and was found to have no statistical difference.Conclusions: We were able to conclude that a simple cataract extraction can help treat two most common causes of blindness, cataract and glaucoma and the technique of cataract surgery used does not influence the change brought about in the angle.

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Immune status in sarcoidosis: one size does not fit all

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1306 ◽

2020 ◽

Vol 90 (3) ◽

Author(s):

Ilias Papanikolaou ◽

Hidenobu Shigemitsu ◽

Andreas Afthinos

Keyword(s):

Immune Status ◽

White Blood Cells ◽

Inverse Correlation ◽

Retrospective Chart Review ◽

Cell Immunity ◽

Caucasian Origin ◽

Group A ◽

Group B ◽

Serological Data ◽

Group D

B-cell immunity and immunoglobulins are less commonly affected in sarcoidosis. We aimed to evaluate immune status in sarcoidosis patients. Retrospective chart review of sarcoidosis patients attending a out-patient clinic over 3 months period. Immunoglobulins levels were recorded (A, M, G, E) along with clinical and serological data. They were divided in group A (normal IgG), group B (increased IgG), group C (decreased IgG) and group D (decreased IgG and IgM and/or IgA). Of 50 subjects, 68% were females and 62% of Caucasian origin. 22 (44%) had normal IgG levels, 16 (32%) had increased IgG levels, 10 (20%) had hypogammaglobulinemia and 2 (4%) had combined hypogammaglobulinemia, diagnosed with combined sarcoidosis and common variable immunodeficiency. Decreased IgA values was found in groups C and D. IgE was high in group B. Globulin was increased in group B and decreased in groups C and D. Decreased neutrophils were found in group D (all statistically significant). Correlation analysis showed significant association of angiotensin converting enzyme with IgA and IgM, inverse correlation of IgG with white blood cells and neutrophils, of IgA with globulin and inverse with albumin and of calcium with albumin. Most sarcoidosis patients have normal or increased immunoglobulin levels, that correlate with serum biomarkers of disease activity. Hypogammaglobulinemia may reflect treatment side effects and accompanied by blood leukocytosis. Combined severe immunodeficiency occurs in sarcoidosis.

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Evaluation of the Sepacell RS-2000® (LeukoConnect) Sterile Dock Leukocyte Reduction Filter Set with Red Blood Cells Collected using Trima.

Blood ◽

10.1182/blood.v104.11.4113.4113 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4113-4113

Author(s):

Sandy C. Campbell ◽

Jennifer E. Mauldin ◽

Kristy L. McShan ◽

M. Dean Elfath

Keyword(s):

Blood Cell ◽

Ambient Temperature ◽

Red Blood Cell ◽

Limit Of Detection ◽

Hold Time ◽

Additional Time ◽

Filtration Time ◽

Group A ◽

Filtration Condition ◽

Group B

Abstract As automated red blood cell (RBC) collections become more prevalent, sterile dock filtration will continue to be an important means of leukoreduction (LR). This study evaluated the performance of the Baxter Sepacell RS-2000 sterile dock leukocyte reduction filter set with RBCs collected using Trima, which were filtered either immediately at ambient temperature, or refrigerated and then filtered 6–8 or 68–72 hours post-collection. 180 RBC units were collected using Trima (Gambro BCT, Lakewood, CO) and filtered with the Sepacell RS-2000 (Baxter Healthcare, Deerfield, IL). Units within Group A (n=60) were filtered at ambient temperature immediately after collection. Units within Group B (n=60) and C (n=60) were refrigerated and filtered at 6–8 or 68–72 hours post-collection respectively. Pre- and Post-filtration hematocrits were performed on the Cell-Dyn 3700 (Abbott Laboratories, Abbott Park, IL) to determine RBC percent recovery. Residual leukocytes in the final product were counted using either the FACSCalibur flow cytometer (BD Biosciences, San Jose, CA). Relevant data is presented in Table 1 below. This study demonstrated that the Sepacell RS-2000 (LeukoConnect) sterile dock filter yielded red cell units that met or exceeded the FDA and AABB standards for leukoreduction when filtering refrigerated red blood cell (RBC) units collected on Trima at 6–8 or 68–72 hours post-collection. 60 out of 60 (100%) LR-RBC units in Groups B and C contained residual white blood cell (WBC) counts at or below the limit of detection of 0.3 x 105. 55 of 60 (92%) LR-RBC units in Group A contained residual WBC < 5x106. 38 of 60 (63 %) LR-RBC units within this group contained residual WBC = 1x106. The hold-time prior to ambient filtration for Group A averaged 1:37 ± 0:18. Filtration was initiated < 3 hours post-collection for all units within this group. There is speculation that a correlation may exist between the temperature of the unit at the time of filtration and leukocyte reduction performance for this filtration condition. This correlation was not assessed by this study and warrants further investigation. It was also noted that 11 out of 180 total units (6%) achieved RBC recovery results slightly less than 85%. Unexpected variability in volume recovery for these units can be attributed to inadequate drainage time of the filter. Allowing additional time for complete drainage of the filter would be expected to result in all units achieving > 85% recovery. Table 1 Parameters Group A Group B Group C Mean ± SD (n=60) (n=60) (n=60) Storage & Filtration Condition Ambient (< 3hrs) 1–6°C (6–8hrs) 1–6°C (68–72hrs) Filtration Time (min) 11 ± 1 24 ± 5 27 ± 6 Residual WBC count (1x106) 1.81 ± 3.33 0.30 ± 0.00 0.30 ± 0.00 % RBC Recovery 88 ± 2 87 ± 2 88 ± 2

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Macrocytosis in COPD and Course of the Disease

Blood ◽

10.1182/blood.v110.11.3747.3747 ◽

2007 ◽

Vol 110 (11) ◽

pp. 3747-3747

Author(s):

Zisis Kontoninas ◽

Fotios Girtovitis ◽

Georgia Kaiafa ◽

George Ntaios ◽

Zoi Saouli ◽

...

Keyword(s):

Clinical Status ◽

Chronic Obstructive Lung Disease ◽

Inverse Correlation ◽

Mean Value ◽

Trigger Factor ◽

Chronic Obstructive ◽

Female Group ◽

Unexpected Result ◽

Group A ◽

Group B

Abstract INTRODUCTION: Macrocytosis (MCV>94fl) is frequently observed at patients suffering from chronic obstructive pulmonary disease (COPD) with or without respiratory insufficiency. Recent studies have demonstrated the role of erythropoietin massive excretion subsequent to hypoxemia as a trigger factor in excessive marrow erythropoiesis. Thus, a large number of immature red cells are released in peripheral blood leading to macrocytosis. AIM: To determine possible correlation between macrocytosis and severity of he disease in patients with COPD. PATIENTS AND METHODS: Thirty eight patients (mean age: 62,16±10,88 years, twenty nine male-Group A and nine female-Group B) with COPD were attended regarding their clinical status for one year, diagnosed according to spirometric classification of COPD based on post-bronchodilator FEV1 (Global Initiative for Chronic Obstructive Lung Disease, 2006). All patients were smokers suffered from mild or moderate COPD (FEV1/FVC <0,70, FEV1≥50% predicted, with PaO2 more than 60mmHg). MCV and hematocrit were measured separately for male and female additionally to the whole sample. Exacerbations considered to be happen when dyspnea or PaO2<60mmHg occurred. Patients with anemia, hematological malignancy, hypothyroidism, heart or renal failure and diabetes mellitus excluded. RESULTS: Mean value for MCV was 98,84±2,66 fl (range:95–107 fl). Average for Group A estimated at 99,52±2,92 (range: 95–107) and for Group B at 96,87±1,40 (range: 95–99). Mean value of exacerbations for both groups in one’s year period was 0,89±0,61 (range :0–2), that was not significantly different from those concerning Group A and Group B (0,79±0,60, 1,22±0,74 respectively). Inverse correlation between MCV and number of exacerbations was statistically significant (r = − 0,43, p<0,01). That correlation was more apparent for Group A (r = −0,45, p<0,01) than Group B (r = −0,35, p<0,05). Mean value of hematocrit was determined at 45,92 ± 3,77 (range: 40–54). Correlation between MCV and Ht was not significant (r=0,2). CONCLUSIONS: An unexpected result revealed considering that elevated MCV in patients with mild to moderate COPD correlates with fewer exacerbations of the disease. A game of statistics or something more important for the pathophysiology of mild COPD?

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Auditory Countermeasures for Sleep Inertia: An Ecological Study Examining the Influence of Melody and Rhythm

10.1101/2020.03.03.974667 ◽

2020 ◽

Author(s):

Stuart J. McFarlane ◽

Jair E. Garcia ◽

Darrin S. Verhagen ◽

Adrian G. Dyer

Keyword(s):

Negative Symptoms ◽

Ecological Study ◽

Modern Society ◽

Response Speed ◽

Sound Design ◽

Sleep Inertia ◽

Significant Difference ◽

Group A ◽

Attentional Lapses ◽

Group B

AbstractSleep inertia is the potentially harmful decline in cognition that occurs upon and following awakening. Sound has been shown to counteract the negative symptoms of sleep inertia, with a recent study revealing that an alarm perceived as melodic by participants displayed a significant relationship to reports of reductions in perceived sleep inertia. This current research builds on these findings by specifically testing the effect melodic and rhythmic stimuli exhibit on sleep inertia for subjects awakening in their habitual environments. Two test Groups (A & B; N = 10 equally) completed an online psychomotor experiment and questionnaire in two separate test sessions immediately following awakening from nocturnal sleep epochs. Both groups responded to a Control stimulus in the first session, while in the second session, Group A experienced a Melodic treatment, and Group B the Rhythmic. The results show that the melodic treatment significantly decreased attentional Lapses, False Starts and had a significantly improved PVT Performance Score than the Control. There was no significant result for Reaction Time or Response Speed. Additionally, no significant difference was observed for all PVT metrics between the Control – Rhythmic conditions. The results support melodies potential to counteract symptoms of sleep inertia by the observed increase in participant vigilance following waking. Specifically, a melodically rhythmic contour is highlighted as a significant musical treatment noteworthy of consideration when designing alarm compositions for the reduction of sleep inertia. As auditory assisted awakening is a common within modern society, improvements in alarm sound design may have advantages in domestic and commercial settings.

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