Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls

Background The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. Methods An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal–Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen’s d and Hedge’s effect size, as appropriate. Results The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). Conclusion Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.

Parental Mentalizing During a Pandemic: Use of Mental-State Language on Parenting Social Media Before and During the COVID-19 Pandemic

The COVID-19 pandemic has been a demanding caregiving context for parents, particularly during lockdowns. In this study, we examined parental mentalization, parents’ proclivity to consider their own and their child’s mental states, during the pandemic, as manifested in mental-state language (MSL) on parenting social media. Parenting-related posts on Reddit from two time periods in the pandemic in 2020, March to April (lockdown) and July to August (postlockdown), were compared with time-matched control periods in 2019. MSL and self–other references were measured using text-analysis methods. Parental mentalization content decreased during the pandemic: Posts referred less to mental activities and to other people during the COVID-19 pandemic and showed decreased affective MSL, cognitive MSL, and self-references specifically during lockdown. Father-specific subreddits exhibited strongest declines in mentalization content, whereas mother-specific subreddits exhibited smaller changes. Implications on understanding associations between caregiving contexts and parental mentalization, gender differences, and the value of using social-media data to study parenting and mentalizing are discussed.

Impact of COVID-19 on Hospital Admissions for COPD Exacerbation: Lessons for Future Care

Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. Acute exacerbations (AECOPD) are common and often triggered by viral infection. During the COVID-19 pandemic social restrictions, including ‘shielding’ and ‘lockdowns’, were mandated. Multiple, worldwide studies report a reduction in AECOPD admissions during this period. This study aims to assess the effect of the pandemic and Lockdown on the rates of admission with AECOPD and severity of hospitalised exacerbations in the North-East of England. Materials and Methods: Data were extracted for patients presenting with a diagnosis of AECOPD or respiratory failure secondary to AECOPD during the ‘COVID-19 period’ (26/3/20–31/12/20) and a date-matched control period from the year previous. We present descriptive statistics and regression analysis of the effects of the COVID-19 period on the rates of hospital admission. Results: Compared to the matched control period, the COVID-19 period was associated with fewer AECOPD admissions (COVID-19 = 719, control = 1257; rate ratio 0.57, p < 0.001) and shorter length of stay (COVID-19 = 3.9 ± 0.2, control = 4.78 ± 0.2 days; p = 0.002), with similar in-hospital plus 30-day post-discharge mortality. Demographics were similar between periods. Only six patients had a positive COVID-19 PCR test. Conclusion: During the COVID-19 period there was a substantial reduction in AECOPD admissions, but no increase in overall severity of exacerbations or mortality. Rather than fear driving delayed hospital presentation, physical and behavioural measures taken during this period to limit transmission of COVID-19 are likely to have reduced transmission of other respiratory viruses. This has important implications for control of future AECOPD.

Prevalence of comorbidities and concomitant medication use in acromegaly: analysis of real-world data from the United States

Purpose Patients receiving treatment for acromegaly often experience significant associated comorbidities for which they are prescribed additional medications. We aimed to determine the real-world prevalence of comorbidities and concomitant medications in patients with acromegaly, and to investigate the association between frequency of comorbidities and number of concomitantly prescribed medications. Methods Administrative claims data were obtained from the IBM® MarketScan® database for a cohort of patients with acromegaly, identified by relevant diagnosis codes and acromegaly treatments, and a matched control cohort of patients without acromegaly from January 2010 through April 2020. Comorbidities were identified based on relevant claims and assessed for both cohorts. Results Overall, 1175 patients with acromegaly and 5875 matched patients without acromegaly were included. Patients with acromegaly had significantly more comorbidities and were prescribed concomitant medications more so than patients without acromegaly. In the acromegaly and control cohorts, respectively, 67.6% and 48.4% of patients had cardiovascular disorders, the most prevalent comorbidities, and 89.0% and 68.3% were prescribed > 3 concomitant medications (p < 0.0001). Hypopituitarism and hypothalamic disorders, sleep apnea, malignant neoplasms and cancer, and arthritis and musculoskeletal disorders were also highly prevalent in the acromegaly cohort. A moderate, positive correlation (Spearman correlation coefficient 0.60) was found between number of comorbidities and number of concomitant medications in the acromegaly cohort. Conclusion Compared with patients without acromegaly, patients with acromegaly have significantly more comorbidities and are prescribed significantly more concomitant medications. Physicians should consider the number and type of ongoing medications for individual patients before prescribing additional acromegaly treatments.

Humoral Response among Patients with Interstitial Lung Disease Vaccinated with the BNT162b2 SARS-Cov-2 vaccine - A Prospective Cohort Study

Background: Patients with interstitial lung disease (ILD) are at high risk of severe COVID-19 infection. Additionally, their anti-inflammatory and antifibrotic treatment may cause immunosuppression. Nevertheless, their ability to mount an adequate immune response to messenger RNA SARS-CoV-2 vaccines was not evaluated. We aimed to evaluate the humoral response after the BNT162b2 vaccine among idiopathic pulmonary fibrosis (IPF) patients treated with antifibrotic therapy and among non-IPF ILD patients treated with anti-inflammatory therapy.Methods: We conducted an observational prospective cohort study to evaluate the rate of anti-spike (S-IgG) antibodies after two doses of the BNT162b2 vaccine in patients with ILD. The cohort included 40 patients with idiopathic pulmonary fibrosis (IPF) treated with anti-fibrotic therapy and 29 patients with non-IPF ILD treated with anti-inflammatory therapy. For S-IgG titer measurement one serology test was drawn from all patients 4-6 months after the second vaccine dose. Two age and sex matched control groups were created from a healthy control cohort of 107 patients. The study was conducted in Rabin Medical Center (Israel) between June to August 2021.Results: All patients in the anti-fibrotic arm were seropositive (40/40), corresponding to the matched control group (P=1.0). The antifibrotic arm had a significantly lower median antibody titer in comparison to the matched control group (361.10 [ IQR, 207-811] AU/ml vs 820.75 [IQR, 459-1313] AU/ml; P<0.001). Only 48.3% (14/29) of patients in the anti-inflammatory arm were seropositive in comparison to 100% (29/29) in the healthy control group (P<0.001). The anti-inflammatory arm had a significantly lower median antibody titer in comparison to the healthy control group (39.6 [ IQR, 4.25-165] AU/ml vs 970.1 [IQR, 505-1926] AU/ml; P<0.001). Conclusion: IPF patients treated with antifibrotic therapy mount an adequate immune response after 2 doses of the BNT162b2 vaccine, maintain a 100% seropositivity rate, 4-6 months after vaccination. However, their antibody titer was reduced in comparison to a healthy control group. Among patients with non-IPF ILD, treated with anti-inflammatory therapy, 48% were seronegative 4-6 months after the second vaccine dose, moreover treatment with rituximab caused significant immunosuppression, even in comparison to other anti-inflammatory treatments.

The Spheno-Occipital Synchondrosis and Morphometry of Sella Turcica Association with Different Phenotype Factors Related to Ectopic Eye Tooth/Teeth

Objectives: This study investigates the prevalence of Spheno-Occipital Synchondrosis (SOS) and sella turcica morphometry (STM) association with different phenotype factors related to ectopic eye tooth/teeth (EET) using cone beam computed tomography (CBCT) imaging. Methods: This comparative retrospective study analyzed 252 CBCT images. Subjects in the EET group consisted of 197 CBCT images with the phenotype factor in number, i.e., unilateral (13, n = 62; 23, n = 59) or bilateral (1323, n = 76) and matched control (n = 55). SOS and STM were investigated using 3D OnDemand Software. Seven parameters of STM were measured. To test the association X2 used for SOS prevalence, disparities in STM were tested using ANOVA and post hoc Tukey test. Results: The prevalence of unfused SOS was 48.4% and 16.1% in the 1323 and control groups, respectively. Fused SOS prevalence was quite similar in all four groups. Phenotype factor in number, i.e., unilateral 13, 23, or bilateral EET group showed significant disparities in six out of seven parameters (p = 0.044 to p ≥ 0.001). Additionally, phenotype factor in position, i.e., occlusal, buccal, or palatal group showed insignificant disparities (p = 0.463 to p = 1.00). Conclusion: SOS in the ectopic eye tooth group (EETG) was prevalent in the 1323 and buccal position groups. Differing from previous two-dimensional (2D) studies, there were statistically significant disparities in all seven measured variables of STM among control, and three different phenotype factors in numbers were revealed using three-dimensional (3D) CBCT imaging.

Mahanimbine Improved Aging-Related Memory Deficits in Mice through Enhanced Cholinergic Transmission and Suppressed Oxidative Stress, Amyloid Levels, and Neuroinflammation

Murraya koenigii leaves contain mahanimbine, a carbazole alkaloid, reported with improving cholinergic neuronal transmission and reducing neuroinflammation in the CNS. The current research investigated the effects of mahanimbine on age-related memory deficits, oxidative stress, cholinergic dysfunction, amyloid formation, and neuroinflammation in aged mice (16 months old). Mahanimbine was administered (1 and 2 mg/kg, p.o.) daily to groups of aged mice for 30 days. The Morris water maze (MWM) task was performed to study spatial learning (escape latency (EL) and swimming distance (SD)) and memory (probe test). The levels of malondialdehyde (MDA), glutathione (GSH), acetylcholine (ACh), acetylcholinesterase (AChE), β-amyloid (Aβ1-40 and Aβ1-42), β-secretase (BACE-1), as well as neuroinflammation markers (total cyclooxygenase (COX) and COX-2 expression), were measured from the isolated brain. Mahanimbine reduced the EL time and SD in the MWM test. From the probe trial, the mahanimbine-treated group spent more time in the targeted quadrant related to the age-matched control, which indicated the enhancement of memory retention. From the biochemical tests, the treatment decreased MDA, AChE, Aβ1-40, and Aβ1-42, BACE-1, total COX activity, and COX-2 expression. It also raised the brain GSH and ACh levels in aged mice compared to age-matched control. These results have supported the reversal of memory dysfunctions by mahanimbine in aged mice and hypothesized that it could be a potential target to treat age-related neurodegenerative disease.

Within-Breath Oscillatory Mechanics in Horses Affected by Severe Equine Asthma in Exacerbation and in Remission of the Disease

Oscillometry is a technique that measures the resistance (R) and the reactance (X) of the respiratory system. In humans, analysis of inspiratory and expiratory R and X allows to identify the presence of tidal expiratory flow limitation (EFLt). The aim of this study was to describe inspiratory and expiratory R and X measured by impulse oscillometry system (IOS) in horses with severe asthma (SEA) when in clinical remission (n = 7) or in exacerbation (n = 7) of the condition. Seven healthy, age-matched control horses were also studied. Data at 3, 5, and 7 Hz with coherence > 0.85 at 3 Hz and >0.9 at 5 and 7 Hz were considered. The mean, inspiratory and expiratory R and X and the difference between inspiratory and expiratory X (ΔX) were calculated at each frequency. The data from the three groups were statistically compared. Results indicated that in horses during exacerbation of severe asthma, X during expiratory phase is more negative than during inspiration, such as in humans in presence of EFLt. The evaluation of X during inspiration is promising in discriminating between horses with SEA in remission and control horses.

Characteristic Personality Traits of Multiple Sclerosis Patients—An Unicentric Prospective Observational Cohort Study

Background and objectives: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. Methods and materials: Patients with relapsing–remitting MS along with a sex- and age-matched control group were included. All subjects completed the DECAS Personality Inventory and an additional form including demographic characteristics. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed using SPSS. Results: 122 subjects were included, out of which 61 were in the patient group, mostly females (71.31%) with a mean age of 42.06 ± 10.46 years. Mean duration of disease was 10.18 ± 5.53 years and mean EDSS score was 2.09; 36% of patients were treated with Interferon-beta 1a. Subjects in the patient group presented significantly lower scores for extraversion (p = 0.036), specifically those with higher EDSS score, even after adjusting for possible confounders (age, sex, marital status, early retirement, alcohol, and tobacco consumption). Additionally, regarding orientation in life, MS patients were more often philosophers (p = 0.001), especially young males, whereas the dominant emotional feeling was less common, the actor profile (p = 0.022). Regarding task involvement, MS patients were often passive and compassionate concerning other people. Higher EDSS score also correlated with avoidant (p = 0.006) and melancholic (p = 0.043) personality traits. Subjects with higher education associated more often pragmatic, experimenter, popular, and optimist traits, whereas the elderly had actor, authoritarian, and experimenter profiles. Conclusions: Some MS patients may have reduced levels of extraversion and specific personality traits compared to age- and sex-matched subjects. Determining the exact personality profile might help the neurologist to establish a better therapeutic alliance and to apply specific interventions.