title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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Statistics | Values are summarized as mean (standard deviation) or median (interquartile range). Continues data of normal distribution were compared using students t-test. Within-individual comparisons between baseline and follow-up echocardiographies were performed using the paired t-test. Fisher’s Exact test was used to compare c... | PMC10673982 | ||
Sample size calculation | To detect a clinically meaningful difference in changes in GLS of 1% with a standard deviation of 1.5 and with a two-tailed α = 0.05 and 1-β = 0.8 in a 1:1 randomization design, 21 patients in each group were needed. A total of 50 patients were included to account for potential dropouts. | PMC10673982 | ||
Results | DILATED CARDIOMYOPATHY, ISCHEMIC HEART DISEASE, ATRIAL FIBRILLATION, IHD, MINERALOCORTICOIDS | Fifty patients with low normal to moderately reduced LVEF were randomized: 26 patients to the intervention group and 24 to the control group. The participants had a mean age of 58 years (SD 14) and 81% were male. The mean p-K was 3.95 mmol/l (SD 0.19), mean LVEF was 48% (SD 7), and mean GLS was − 14.6% (SD 3.1%). Basel... | PMC10673982 | |
Follow-up | ATRIAL FIBRILLATION, MAY, HEART | All patients completed the study and all patients in the intervention group reported full compliance to medication during the study period. Patients in the intervention group were given a mean daily dose of oral potassium supplement of 2,700 mg (~ 36 mmol) and mean dose of MRA of 23 mg. The mean difference in changes i... | PMC10673982 | |
Systolic function | CONTRACTION | At follow-up, the intervention group had improved myocardial longitudinal contraction measured by GLS with a mean difference in changes of -1.0% (-2.0; -0.02), P < 0.05 compared to controls (Fig.
Mean GLS, e’, E/e’ along with 95% Confidence Interval in the intervention- and control group at baseline and follow-up | PMC10673982 | |
Diastolic function | The intervention group had improved diastolic function as measured by e’ with mean difference in changes of 0.9 cm/s (0.02; 1.7), P = 0.04 and improvement in E/e’ with mean difference in changes of -1.5 (-2.9; -0.1), P = 0.03 compared to controls. No significant difference in changes was found between groups for E, A, ... | PMC10673982 | ||
Relation between p-K and mechanical function | REGRESSION | In multiple linear regression models, no correlation was found between p-K and any of the echocardiographic parameters that were improved with the intervention. GLS (ß=-0.9, P = 0.22, R | PMC10673982 | |
Sensitivity analysis | Patients in the intervention group only receiving potassium as a supplement (n = 15) had similar baseline characteristics as the control group (Supplementary Table Interobserver variability analysis showed close correlation between the two independent observers. Intraclass correlation coefficient: ICC = 0.72, P = 0.006... | PMC10673982 | ||
Safety | renal failure | RENAL FAILURE, ELECTROLYTE DISTURBANCE | No patient in either group was hospitalized due to electrolyte disturbance or renal failure between baseline and follow-up. | PMC10673982 |
Discussion | This study was designed to determine whether increased potassium levels influence systolic and diastolic myocardial performance. It is the first randomized intervention study to indicate that targeting high-normal p-K levels using dietary guidance, oral potassium supplements and MRAs improves echocardiographic indices ... | PMC10673982 | ||
The effects of potassium on cardiovascular risk | arrhythmias, hypertensive, strokes | ARRHYTHMIAS, STROKES | The protective effects of high potassium intake on cardiovascular outcomes have been reported in several studies. The potassium-induced lowering effect on blood pressure in hypertensive patients and reduction in the risk of strokes is particularly well documented [To our knowledge this is the first study to investigate... | PMC10673982 |
Possible mechanism for improved myocardial function with higher potassium levels | myocardial Na, heart failure, hypokalemic | HEART FAILURE, DEPOLARIZATION | Changes in potassium concentrations in- and around the cardiomyocyte affect several aspects of myocardial electrophysiology which could result in altered mechanical function. P-K determines the resting membrane potential of the myocyte and significantly impacts depolarization velocity. Additionally, cardiac repolarizat... | PMC10673982 |
Strength and limitations | The randomized controlled design strengthens the causal inference of the findings. The present study was open labelled and therefore patients in the control group could have been motivated to increase their potassium intake independent of the trial. This is not likely to be an important factor as p-K levels in the cont... | PMC10673982 | ||
Conclusion | Targeting p-K between 4.5 and 5.0 mmol/l with dietary guidance on a potassium rich diet, oral potassium supplements and MRAs improved indices of systolic and diastolic left ventricular function in patients with low-normal to moderately reduced LVEF. These findings may in part explain previously reported beneficial effe... | PMC10673982 | ||
Acknowledgements | None. | PMC10673982 | ||
Authors’ contributions | All co-authors have contributed to the study conception and design. Material preparation and data collection were done by Ulrik Winsløw, Tharsika Sakthivel, Chaoqun Zheng, and Emil Frandsen and analysis were performed by Ulrik Winsløw, Christian Jøns, Henning Bundgaard, and Niels Risum. The first draft of the manuscrip... | PMC10673982 | ||
Funding | HEART | Open access funding provided by Royal Library, Copenhagen University Library. This study was supported by the Danish Council for Independent Research, Medical Science, the Danish Heart Foundation, Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond, the Hartmann Foundation, and the Novo Nordisk Foundation. Th... | PMC10673982 | |
Data Availability | The data is available from the corresponding author on reasonable request in accordance with the Danish Data Protection Act and the General Data Protection Regulation and after the approval by the steering committee of the POTCAST trial. | PMC10673982 | ||
Declarations | PMC10673982 | |||
Disclosures | The authors report no conflicts of interest. HB received lecture fees from Amgen, MSD, BMS and Sanofi. | PMC10673982 | ||
Transparency statement | The authors had full access to and take full responsibility for the integrity of the data. All authors have read and agree to the manuscript as written. | PMC10673982 | ||
Competing interests | The authors declare no competing interests. | PMC10673982 | ||
References | PMC10673982 | |||
Abstract | PMC9939179 | |||
Objective | DISEASE, MULTIPLE MYELOMA, MULTIPLE MYELOMA (MM), IMMUNE DEFICIENCY | Despite the availability of new agents, elderly patients with multiple myeloma (MM) usually present with poor outcomes due to the heterogeneity of disease conditions, especially immune deficiency. Regulatory B cells (Bregs) can be involved in immune defects by exerting immune regulatory functions in MM. In order to pro... | PMC9939179 | |
Methods | In this open‐label, non‐interventional, prospective study in the real world, 159 newly diagnosed MM (NDMM) patients over | PMC9939179 | ||
Results | Based on the CEMM2021 model, 147 patients had received at least one cycle of induction therapy, including bortezomib/dexamethasone (Bd) ( | PMC9939179 | ||
Conclusions | MM | MULTIPLE MYELOMA, DISEASE, IMMUNE DEFICIENCY | For the elderly NDMM, the CEMM2021 algorithm in our center might provide a valuable reference for the guidance of therapeutic strategies, with the combination of Bregs resulting in an effective and clinically meaningful prediction in contemporary treatment.The management of elderly patients with MM remains challenging ... | PMC9939179 |
INTRODUCTION | Multiple myeloma, tumor, MM | MULTIPLE MYELOMA, MULTIPLE MYELOMA, TUMOR | Multiple myeloma (MM), which is the second most common hematological tumor with the mean annual age‐adjusted incidence of around six per 100,000 per year in the European and American areas,Recently, regulatory B cells (Bregs) have been proven to be involved in immune defects by exerting immune regulatory functions.Aimi... | PMC9939179 |
METHODS | PMC9939179 | |||
Patients and study design | ONCOLOGY, WEST, DISEASE | The prospective study was designed to be an open‐label, noninterventional, observational study in real‐world clinical practice, detailing how to optimize and stratify the use of current therapy regimens for elderly patients with NDMM (chiCTR2000029925). NDMM patients 65 years old and above were sequentially recruited b... | PMC9939179 | |
Treatment algorithm | MULTIPLE MYELOMA | To ascertain the best possible qualitative stratification, the final reasonable treatment decisions for all the enrolled patients were discussed with the The treatment algorithm and details for the elderly newly diagnosed with multiple myeloma. BCd, bortezomib/cyclophosphamide/dexamethasone; BRd, bortezomib/lenalidomid... | PMC9939179 | |
Examination of bone marrow‐derived CD19 | The detailed procedures of examination of BM‐derived Bregs by flow cytometry were described in our previous work. | PMC9939179 | ||
FDG‐PET/CT scan | The operation of FDG‐PET/CT scan was carried out following the guidelines of the European Association of Nuclear Medicine. | PMC9939179 | ||
Statistics analysis | The analysis of differences between groups was calculated by the t test or ANOVA for continuous variables and the chi‐square test or Fisher's exact test for categorical variables. Univariate analysis of survival curves was conducted according to the Kaplan–Meier method and log‐rank test. Cox proportional hazards model ... | PMC9939179 | ||
RESULTS | PMC9939179 | |||
Baseline characteristics | multiple myeloma, Renal insufficiency, MM | MULTIPLE MYELOMA, DISEASE, ONCOLOGY, T(4;14), DELETION, T(14;16), RENAL INSUFFICIENCY | Between January 1, 2017 and April 1, 2021, a total of 159 NDMM no younger than 65 years old were recruited with a median age of 70 years old and 25.2% of MM patients were more than 75 years old. The baseline clinical characteristics of the elderly MM patients were shown in Table Baseline characteristics and treatment e... | PMC9939179 |
Treatment characteristics | Among them, 147 (92.5%) elderly NDMM patients had received at least one cycle of induction therapy, and the treatment details were illustrated in Figure In the Rd group, four (14.8%) patients with hemoglobin less than 70 g/L and 10 (37.0%) patients with platelets less than 150 × 10 | PMC9939179 | ||
Treatment efficacy | MM | Response assessments were available for 138 elderly MM patients and are summarized in Table The median treatment cycles of Bd, Bd + X, and Rd regimens were six, four, and eight, respectively ( | PMC9939179 | |
Survival outcomes | multiple myeloma | MULTIPLE MYELOMA, ONCOLOGY | The median follow‐up time was 20.8 months for the entire cohort. The median PFS was 24.5 months (95% Confidence interval [CI] 18.2–30.7) and the median OS was not reached, while the estimated 24‐month OS rate was 75.4%. At the time of analysis, 67 (42.1%) patients had progressed, and 34 (21.4%) had died in total.The me... | PMC9939179 |
Characteristics of bone marrow regulatory B cells and PET‐CT scan in the elderly NDMM patients | MM | MULTIPLE MYELOMA | Flow cytometry analysis was applied to characterize the BM‐derived CD19Analysis of bone marrow‐derived regulatory B cells and PET/CT scan in the elderly with multiple myeloma. (A). Bone marrow from MM patients was stained with CD19, CD24, and CD38 by flow cytometry. Bregs are phenotypically identified as a distinct sub... | PMC9939179 |
DISCUSSION | MM | RECRUITMENT | There is no consensus on the treatment of elderly patients with MM in real‐world practice, although clinical trials have proven the efficacy of novel agents in MM. The management of elderly MM is challenging due to various comorbidities and compromised health status, generally ineligible for clinical trials limiting th... | PMC9939179 |
CONCLUSION | PLASMA CELL DISORDER | With the aging of the population, the interest in studies concerning elderly patients with NDMM, the most common malignant plasma cell disorder, has dramatically increased. Our data reported in Southwest China herein indicates that the treatment algorithm described above might provide a valuable reference for the guida... | PMC9939179 | |
AUTHOR CONTRIBUTIONS | PMC9939179 | |||
FUNDING INFORMATION | This study was supported by the National Natural Science Foundation of China for the general program (817780218) and the Natural Science Foundation of Sichuan Province (2022NSFSC1299). | PMC9939179 | ||
CONFLICT OF INTEREST | There is no conflict of interest to declare. | PMC9939179 | ||
ETHICS APPROVAL | WEST | This study was approved by the ethics committee of West China Hospital, Sichuan University (WCHSCU) and all the procedures involving human participants have complied with the Helsinki Declaration. | PMC9939179 | |
CLINICAL TRIAL REGISTRATION NUMBER | chiCTR2000029925. | PMC9939179 | ||
INFORMED CONSENT | All the participants provided written informed consent. | PMC9939179 | ||
Supporting information |
Figure S1
Click here for additional data file.
Table S1
Click here for additional data file. | PMC9939179 | ||
ACKNOWLEDGMENTS | We are grateful to all patients and their families and study group members, including co‐investigators and research nurses. | PMC9939179 | ||
DATA AVAILABILITY STATEMENT | The data that support the findings of this study are available on request from the corresponding author. | PMC9939179 | ||
REFERENCES | PMC9939179 | |||
Objectives | Orthodontic | PLAQUE | Orthodontic patients struggle with interdental cleaning calling for simpler mechanical devices to reduce the high plaque levels. The present study aimed to compare the cleansing efficacy of an oral irrigator with that of dental flossing in patients with fixed braces after 4 weeks of home-use. | PMC10160186 |
Materials and methods | PLAQUE, GINGIVAL BLEEDING | The study design is a randomized and single-blinded cross-over study. After 28 days using the products at home, hygiene indices (Rustogi Modified Navy Plaque Index (RMNPI); gingival bleeding index (GBI)) were compared between test (oral irrigator) and control product (dental floss). | PMC10160186 | |
Results | Seventeen adult individuals finalized the study. After 28 days of cleaning with the oral irrigator, RMNPI was 54.96% (46.91–66.05) compared to 52.98% (42.75–65.60) with dental floss ( | PMC10160186 | ||
Conclusions | GINGIVAL BLEEDING, PLAQUE | Oral irrigators do not remove plaque and reduce gingival bleeding as efficiently as dental floss in easily accessible regions. However, in posterior regions, where the patients struggled with the application of dental floss, the oral irrigator showed similar results. | PMC10160186 | |
Clinical relevance | orthodontic | Oral irrigators should only be recommended to orthodontic patients who cannot use interdental brushes and are not compliant with dental flossing. | PMC10160186 | |
Keywords | Open access funding provided by University of Innsbruck and Medical University of Innsbruck. | PMC10160186 | ||
Introduction | carious lesions, gingivitis, young orthodontic, enamel decalcification, orthodontic, teeth [In orthodontic | PERIODONTAL DISEASE, GINGIVITIS | Recent studies have shown that interdental cleaning in a high frequency (4 to 7 times per week) is associated with less carious lesions, less periodontal disease, and a lower number of missing teeth [In orthodontic patients, fixed braces promote supra- and subgingival accumulation of biofilm by impeding oral hygiene re... | PMC10160186 |
Material and methods | This study was approved by the Ethics committee of the Medical University of Innsbruck, Austria (ID AN 5123). The study was conducted in accordance with the 1964 Helsinki declaration and its later amendments. Prior to inclusion all subjects signed an informed written consent. | PMC10160186 | ||
Study subjects | gingivitis | ADHESION, SYSTEMIC DISEASE, GINGIVITIS, PLAQUE | Twenty adult subjects of the University Hospital of Orthodontic Dentistry, Innsbruck, Austria, were recruited in the period from November 5th, 2020, to January 9th, 2021. Inclusion criteria were fixed braces attached buccally at a minimum of four teeth per quadrant and existing contact points between all teeth. Exclusi... | PMC10160186 |
Clinical intervention | bleeding, tooth | BLEEDING, GINGIVAL BLEEDING, PLAQUE, PCP, PLAQUE | The cleansing efficacy of the microburst technology (The study design consisted of four appointments for each subject. At the first appointment all probands were thoroughly informed about the study protocol, inclusion and exclusion criteria were surveyed, and an informed consent was signed. Moreover, baseline hygiene i... | PMC10160186 |
Statistical analysis | GINGIVAL BLEEDING, PLAQUE | The sample size calculation was based on mean values and standard deviations of overall plaque scores provided by Heiß-Kisielewsky et al. comparing the cleansing efficacy of microburst technology (On a proband-level, RMNPI values were calculated as the total number of areas with plaque present divided by the total numb... | PMC10160186 | |
Results | Twenty individuals were recruited. Seventeen participants (seven females and ten males) finished the study with a mean age of 27.12 ± 9.23 (range 18–49) years. The drop-out rate was 15%. One participant quit because of scheduling difficulties; two participants were excluded because of antibiotic treatment during the te... | PMC10160186 | ||
Plaque scores | bleeding, tooth | PLAQUE, BLEEDING, GINGIVAL BLEEDING, PLAQUE | At baseline, the median of overall RMNPI was 61.35% (53.29–69.56). After 28 days of interdental cleaning with microburst technology, the median of overall RMNPI was 54.96% (46.91–66.05) and statistically significantly higher than after 28 days of interdental cleaning with the control procedure dental flossing (median o... | PMC10160186 |
Gingival bleeding index | bleeding | GINGIVAL BLEEDING, BLEEDING, GINGIVAL BLEEDING, PLAQUE | At baseline, the median of GBI was 26.45% (range 14.49–31.55). After 28 days of interdental cleaning with the oral irrigator, GBI was 12.96% (7.14–24.31) and statistically significantly higher compared to 8.33% (5.84–15.33) after interdental cleaning with dental floss (Subgroup analysis revealed that unlike the plaque ... | PMC10160186 |
Availability of data and materials | Not applicable for this research. | PMC10160186 | ||
Author contribution | All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Vera Wiesmüller, Desiree Zotz, and Baran Zengin. The first draft of the manuscript was written by Vera Wiesmüller and Ines Kapferer-Seebacher and all authors commented on previous versions o... | PMC10160186 | ||
Funding | Open access funding provided by University of Innsbruck and Medical University of Innsbruck. | PMC10160186 | ||
Declarations | PMC10160186 | |||
Ethical approval | The present study was carried out in accordance with the 1964 Declaration of Helsinki and its later amendments, and ethical approval was obtained by the Ethics committee of the Medical University of Innsbruck, Austria (study ID AN 5123). | PMC10160186 | ||
Informed consent | All subjects signed an informed written consent prior to the study enrolment. | PMC10160186 | ||
Competing interests | The authors declare no competing interests. | PMC10160186 | ||
References | PMC10160186 | |||
Introduction | obesity, Weight loss, weight loss | OBESITY | Weight loss through behavioural weight management interventions can have important health benefits for people with obesity. However, to maximise the health benefits, weight loss must be maintained. Evidence suggests that behavioural weight loss interventions do not exacerbate inequalities in the short term. However, no... | PMC10028366 |
Methods | We conducted a cohort analysis of data from the Weight Loss Referrals for Adults in Primary Care (WRAP) trial ( | PMC10028366 | ||
Results | Of the 1,267 participants in WRAP, 708 had weight change data available. Mean weight change between 1- and 5-years was +3.30 kg (SD 9.10 kg). A 1 year difference in age at baseline was associated with weight change of 0.11 kg ((95% CI 0.06, 0.16), | PMC10028366 | ||
Conclusion | Except for age, we did not find evidence of inequalities in weight change following a behavioural intervention. Findings further support the use of behavioural weight management interventions as part of a systems-wide approach to improving population health. | PMC10028366 | ||
Keywords | PMC10028366 | |||
Introduction | PMC10028366 | |||
Background and Rationale | cancers, weight loss, post-menopausal breast cancers | CANCERS, CARDIOVASCULAR DISEASE, OVERWEIGHT AND OBESITY, TYPE 2 DIABETES, DISEASES | Overweight and obesity are associated with an increased risk of several non-communicable diseases such as type 2 diabetes, cardiovascular disease, and some cancers (for example, bowel and post-menopausal breast cancers) [Inequalities in health outcomes and processes (such as intervention uptake and adherence) are known... | PMC10028366 |
Methods | This study analysed data from the Weight Loss Referrals for Adults in Primary Care (WRAP) trial as a cohort. | PMC10028366 | ||
The WRAP Trial | weight loss | The WRAP trial is a three-group randomised controlled trial of behavioural weight loss interventions. Full information about the trial design has been published elsewhere [ | PMC10028366 | |
Participants | Participants were required to be ≥18-years-old, residing in the UK, and have a BMI of ≥28 kg/m | PMC10028366 | ||
Interventions | HEART | Participants in the behavioural programmes were given vouchers and asked to attend local WW weekly meetings and access WW web tools at no cost for the duration of the intervention (12-weeks or 52-weeks). Participants allocated to the brief intervention were given a 32-page booklet from the British Heart Foundation that... | PMC10028366 | |
Outcomes | Participants completed outcome assessments at baseline, 3-months, 1-year, 2-years, and 5-years. The primary outcome for this analysis was change in weight between 1-year and 5-years.Weight measurements were made at participants' primary care practice or at the research centre by trained clinical or research staff, in l... | PMC10028366 | ||
Statistical Analysis | We analysed data from the WRAP trial as a cohort rather than consider intervention versus control arms separately to estimate intervention effects. We conducted data analyses using Stata v16 (StataCorp. 2019, | PMC10028366 | ||
Sensitivity Analyses | REGRESSION | To investigate the impact of missing data on the findings, we performed a sensitivity analysis using Multiple Imputation by Chained Equations (MICE). MICE assumes that data are missing at random conditional on observed participant characteristics. Variables with ≥5% and <25% missing data had missing values imputed. The... | PMC10028366 | |
Results | PMC10028366 | |||
Participant Characteristics | A total of 1,267 participants were randomised to one of the three groups (211 brief intervention, 528 12-week, 528 52-week intervention). The majority of the recruited participants were women (67.8%) and of white ethnicity (89.7%). Weight data were available for 823 participants at the 1-year follow-up. At 5-year follo... | PMC10028366 | ||
Association between PROGRESS-Plus Criteria and Weight Change from 1- to 5-Years | weight loss | Being 1-year older compared to other participants at baseline was associated with experiencing 0.11 kg less weight regain, or greater weight loss ((95% CI: 0.06, 0.16), | PMC10028366 | |
Sensitivity Analyses | weight loss | Only one variable, education, met the conditions for performing MICE to impute missing data (between 5% and 25% missing data). The observed results using 11 imputed datasets were comparable to the primary analysis, and no associations were identified (online suppl. Table S3).In the sensitivity analysis using only study... | PMC10028366 | |
Discussion | weight loss | REGRESSION | In this study, we explored inequalities in weight change following participation in a weight loss intervention using data from the WRAP trial. Given that 55.5% of participants regained weight between the 1- and 5-year follow-up time points, the coefficients produced from the regression analyses were interpreted as indi... | PMC10028366 |
Comparison with Existing Literature | Inequalities have previously been considered in trial participation and intervention uptake, intervention adherence, and at 1-year follow-up both in the WRAP trial and other UK-based trials of behavioural weight management interventions [In the previous studies that considered differential weight outcomes at 12 months,... | PMC10028366 | ||
Strengths and Limitations | weight loss | This study is the first to consider if there are inequalities in weight loss maintenance following participation in a weight loss trial at the 5-year follow-up time point. The demographics of the WRAP trial sample are similar to those of the UK population in terms of SES and ethnicity [A limitation of our study is the ... | PMC10028366 | |
Implications | obesity, weight loss | OBESITY, DISEASES | Despite obesity being socially patterned, with the exception of age, we did not find evidence of inequalities in weight change following weight loss intervention. Younger participants of behavioural weight management interventions may need additional support when maintaining weight loss following intervention. However,... | PMC10028366 |
Conclusion | Except for age, we did not find evidence of inequalities in weight change following a behavioural intervention, demonstrating that behavioural weight management interventions are unlikely to generate inequalities in weight change following intervention. | PMC10028366 | ||
Statement of Ethics | WEST | Ethical approval for up to 2-year post-randomisation assessment was received by East of England Cambridge East and local approvals from the NRES Committee North West Liverpool Central and the NRES Committee South Central Oxford. Ethical approval for 5-years post-randomisation assessment was received from West Midlands-... | PMC10028366 | |
Conflict of Interest Statement | Obesity, obesity, Jason C.G., Nordisk | OBESITY, OBESITY | WRAP was a publicly funded, independent, investigator-led trial, in which WW provided the intervention at no cost and provided funds for blood sampling and analysis for the first 2-years via an MRC Industrial Collaboration Award. Neither the funders nor WW had any role in the study design, data collection, data analysi... | PMC10028366 |
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