Category: Nevin Manimala

Graefes Arch Clin Exp Ophthalmol. 2024 Feb 28. doi: 10.1007/s00417-024-06421-0. Online ahead of print.

ABSTRACT

PURPOSE: To report short-term outcomes of treatment switch to faricimab in real-world patients with aflibercept-resistant neovascular age-related macular degeneration (AMD).

METHODS: Single-center, retrospective cohort study with chart-review using electronic injection database, electronic medical records, and optical coherence tomography (OCT) data from May to September 2023.

RESULTS: A total of 50 eyes of 46 patients were analyzed. Faricimab treatment led to absence of fluid in 32% of the eyes and a reduction of fluid in 84% of the eyes. There was a statistically significant decrease in central retinal thickness (CRT) and pigment epithelial detachment (PED) height in those that responded to the switch (median difference: – 31 μm, IQR: 55, p < 0.0001 and median difference: – 21 μm, IQR: 36, p < 0.0001, respectively) and a statistically significant increase in CRT (median difference: + 19 μm, IQR: 20, p = 0.0143) and no change in PED height (median difference: + 22 μm, IQR: 64, p = 0.1508) in those that did not. Best-corrected visual acuity (BCVA) showed marginal decrease with low statistical significance. No ocular or systemic safety events were observed.

CONCLUSIONS: Our findings suggest that switching to faricimab is generally safe and effective in patients with neovascular AMD who are otherwise difficult to treat and have residual fluid despite frequent injections with aflibercept. We observed a high rate of morphological response to the treatment switch, improvement of anatomical parameters with about one-third of patients having dry macula following a single injection, and a marginal change in BCVA. Sustainability of these results requires further investigation.

STUDY REGISTRATION: ClinicalTrials.gov registration number: NCT06124677. Date of registration: 09/11/2023, retrospectively registered.

PMID:38416237 | DOI:10.1007/s00417-024-06421-0

J Med Virol. 2024 Mar;96(3):e29468. doi: 10.1002/jmv.29468.

ABSTRACT

Cervical human papillomavirus (HPV) infection is believed to increase the risks of pregnancy failure and abortion, however, whether the uterine cavity HPV infection reduces pregnancy rate or increases miscarriage rate remains unclarified in infertile women undergoing assisted reproductive technology (ART) treatment. Therefore, we aimed to assess ART outcomes in the presence of intrauterine HPV. This was a hospital-based multicenter (five reproductive medicine centers) matched cohort study. This study involved 4153 infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment in five reproductive medicine centers between October 2018 and 2020. The spent embryo transfer media sample with endometrium tissue were collected and performed with flow-through hybridization and gene chips to detect HPV DNA. According to basic characteristics, HPV-positive and negative patients were matched in a ratio of 1:4 by age, body mass index transfer timing, transfer type, and number of embryos transferred. The primary outcome was pregnancy and clinical miscarriage rates in the transfer cycle underwent HPV detection. 92 HPV-positive and 368 HPV-negative patients were screened and analyzed statistically. Univariate analysis showed uterine cavity HPV infection resulted in lower rates of ongoing pregnancy (31.5% vs. 44.6%; p = 0.023), implantation (32.3% vs. 43.1%; p = 0.026), biochemical pregnancy (47.8% vs. 62.5%; p = 0.010), and clinical pregnancy (40.2% vs. 54.3%; p = 0.015) compared with HPV negative group. The infertile female with positive HPV also had a slightly higher frequency of biochemical miscarriage (15.9% vs. 13.0%; p = 0.610) and clinical miscarriage (24.3% vs. 15.5%; p = 0.188). These findings suggest that HPV infection in the uterine cavity is a high risk for ART failure. HPV screening is recommended before ART treatment, which may be benefit to improving pregnancy outcome.

PMID:38415499 | DOI:10.1002/jmv.29468

Curr Med Imaging. 2024 Feb 26. doi: 10.2174/0115734056290762240209071656. Online ahead of print.

ABSTRACT

INTRODUCTION: The diagnosis and characterization of vertebral compression fractures are very important for clinical management. In this evaluation, which is usually performed with diagnostic (conventional) imaging, the findings are not always typical or diagnostic. Therefore, it is important to have new information to support imaging findings. Texture analysis is a method that can evaluate information contained in diagnostic images and is not visually noticeable. This study aimed to evaluate the magnetic resonance images of cases diagnosed with vertebral compression fractures by the texture analysis method, compare them with histopathological data, and investigate the effectiveness of this method in the differentiation of benign and malignant vertebral compression fractures.

METHODS: Fifty-five patients with a total of 56 vertebral compression fractures were included in the study. Magnetic resonance images were examined and segmented using Local Image Feature Extraction (LIFEx) software, which is an open-source program for texture analysis. The results were compared with the histopathological diagnosis.

RESULTS: The application of the Decision Tree algorithm to the dataset yielded impressively accurate predictions (≈95% in accuracy, precision, and recall).

CONCLUSION: Interpreting tissue analysis parameters together with conventional magnetic resonance imaging findings can improve the abilities of radiologists, lead to accurate diagnoses, and prevent unnecessary invasive procedures. Further prospective trials in larger populations are needed to verify the role and performance of texture analysis in patients with vertebral compression fractures.

PMID:38415478 | DOI:10.2174/0115734056290762240209071656

Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056258544231115103528. Online ahead of print.

ABSTRACT

BACKGROUND: In the last few years, coronavirus disease 2019 (COVID-19) has changed human lifestyle, behavior, and perception of life. This disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). In the literature, there are limited studies about the late renal effects of COVID-19 that reflect the systemic involvement of this disease.

AIM: In the present study, we aimed to compare sonoelastographic changes in both kidneys between patients who had totally recovered from COVID-19 and healthy individuals using strain wave elastography (SWE).

METHODS: This study was conducted between June 2021 and May 2022 in Kahramanmaraş City Hospital Department of Radiology. File and archive records were retrospectively evaluated. Basic demographic, laboratory, and renal ultrasonography (USG) and sonoelastographic findings were screened and noted. Two groups were defined to compare sonoelastographic findings. Post-long COVID-19 group had 92 post-long COVID-19 patients, and the comparator group had 9 healthy individuals”. Both groups’ demographic, laboratory, and ultrasound-elastographic findings were assessed.

RESULTS: The post-long COVID-19 group had a higher renal elastographic value than the comparator group (1.52 [0.77-2.3] vs. 0.96 [0.54-1.54], p<0.001). There were no statistically significant differences between the two groups in terms of age (p=0.063), gender (p=0.654), or body mass index (BMI) (p=0.725), however, there was a significant difference observed between the two groups in the renal strain ratio (RSR). According to an ROC analysis, an RSR cutoff of >1.66 predicted post-long COVID-19 with 44.9% sensitivity and 81.9% specificity. (AUC=0.655, p<0.001). A separate ROC analysis was performed to predict post-long COVID-19 with a BMI cutoff of <33.52, kg/m2 sensitivity of 92.4% and specificity of 17% (AUC=0.655, p<0.001).

CONCLUSION: We demonstrated that renal parenchymal stiffness increases with SWE in post-long COVID-19 patients.

PMID:38415466 | DOI:10.2174/0115734056258544231115103528

Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056278130231218073650. Online ahead of print.

ABSTRACT

INTRODUCTION: A recently developed deep-learning-based automatic evaluation model provides reliable and efficient Cobb angle measurements for scoliosis diagnosis. However, few studies have explored its clinical application, and external validation is lacking. Therefore, this study aimed to explore the value of automated assessment models in clinical practice by comparing deep-learning models with manual measurement methods.

METHODS: The 481 spine radiographs from an open-source dataset were divided into training and validation sets, and 119 spine radiographs from a private dataset were used as the test set. The mean Cobb angle values assessed by three physicians in the hospital’s PACS system served as the reference standard. The results of Seg4Reg, VFLDN, and manual measurement were statistically analyzed. The intra-class correlation coefficients (ICC) and the Pearson correlation coefficient (PCC) were used to compare their reliability and correlation. The Bland-Altman method was used to compare their agreement. The Kappa statistic was used to compare the consistency of Cobb angles at different severity levels.

RESULTS: The mean Cobb angle values measured were 35.89° ± 9.33° with Seg4Reg, 31.54° ± 9.78° with VFLDN, and 32.23° ± 9.28° with manual measurement. The ICCs for the reliability of Seg4Reg and VFLDN were 0.809 and 0.974, respectively. The PCC and MAD between Seg4Reg and manual measurements were 0.731 (p<0.001) and 6.51°, while those between VFLDN and manual measurements were 0.952 (p<0.001) and 2.36°. The Kappa statistic indicated VFLDN (k= 0.686, p< 0.001) was superior to Seg4Reg and manual measurements for Cobb angle severity classification.

CONCLUSION: The deep-learning-based automatic scoliosis Cobb angle assessment model is feasible in clinical practice. Specifically, the keypoint-based VFLDN is more valuable in actual clinical work with higher accuracy, transparency, and interpretability.

PMID:38415463 | DOI:10.2174/0115734056278130231218073650

Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056269300231127052836. Online ahead of print.

ABSTRACT

AIM: To identify age-matched healthy volunteers, non-cirrhotic chronic liver disease (CLD) and cirrhotic patients based on portal hemodynamic parameters using 4D flow MRI.

METHODS: A total of 10 age-matched healthy volunteers and 69 CLD patients were enrolled and underwent 4D flow MRI prospectively. 4D flow MR images were processed by an MD in biomedical engineering working on the GTFlow platform. Portal hemodynamic parameters include net flow (mL/cycle), flow volume per second through the lumen (mL/sec), average flow velocity (cm/sec), and maximum flow velocity (cm/sec). The difference in portal hemodynamic parameters of 4D flow MRI was compared among healthy volunteers, non-cirrhotic CLD patients and patients with cirrhosis by one-way ANOVA or Kruskal-Wallis nonparametric test and post hoc tests.

RESULTS: 10 CLD patients without cirrhosis and 56 patients with cirrhosis were eventually included, along with 10 healthy volunteers who were divided into three groups. 3 patients with cirrhosis whose image quality did not meet the requirements were excluded. There were no significant differences in portal hemodynamic parameters among the three groups except portal average velocity (P > 0.05). There was no statistical difference in all portal hemodynamic parameters of 4D flow MRI between healthy volunteers and patients with cirrhosis (P > 0.05). There were significant differences in portal average velocity between non-cirrhotic CLD patients, healthy volunteers and patients with cirrhosis, respectively (11.44±3.93 vs 8.10±2.66, P=0.013; 11.44±3.93 vs 8.60±2.22, P=0.007).

CONCLUSION: Portal average velocity obtained by 4D flow MRI can be an auxiliary means to identify cirrhosis in patients with CLD.

PMID:38415457 | DOI:10.2174/0115734056269300231127052836

J Cosmet Dermatol. 2024 Feb 28. doi: 10.1111/jocd.16254. Online ahead of print.

ABSTRACT

BACKGROUND: The emulgel, a novel drug delivery system, merges emulsion and gel, offering advantages like enhanced stability, precise control over drug release kinetics, and increased drug absorption compared to emulsions alone. Kojic acid (KA) demonstrates potent inhibition of the tyrosinase enzyme, a crucial player in the melanin synthesis pathway.

AIMS: The main objective of this experimental study is to formulate KA within an emulgel framework and assess its stability under various environmental conditions.

METHODS: One percent of KA emulgel and 1% simple gel, serving as the control product, were supplemented with varying concentrations of sodium metabisulfite (SMBS) for its antioxidant properties. The formulations were segregated into four groups and subjected to diverse maintenance and stress conditions over a three-month period. Monthly evaluations of physicochemical alterations were conducted, initially employing digital photography, followed by the extraction of KA and subsequent quantification of its concentration through high performance liquid chromatography (HPLC).

RESULTS: The best formulations for retaining KA among the prepared ones were the 0.25% SMBS KA emulgel and the 0.1% SMBS KA simple gel, capable of retaining 86% and 76% of the initial KA content under stress conditions, respectively (p < 0.0001).

CONCLUSIONS: Regarding to this study, ideal storage condition for KA emulgel and simple gel is in the refrigerator temperatures. Moreover, optimal SMBS concentrations for stability enhancement are 0.25% for emulgel and 0.1% for the simple gel. A significant statistical difference was observed between refrigerated emulgel and simple gel in the retention of KA in the presence of optimum concentration of antioxidants (p < 0.0001).

PMID:38415395 | DOI:10.1111/jocd.16254

Dent Med Probl. 2024 Jan-Feb;61(1):77-83. doi: 10.17219/dmp/150655.

ABSTRACT

BACKGROUND: Platelet-rich fibrin (PRF) is widely used in periodontics for its wound healing potential. Two major variations of PRF are the original leukocyteand platelet-rich fibrin (L-PRF) and the modified lowspeed advanced PRF (A-PRF).

OBJECTIVES: The aim of the present study was to evaluate and compare the conventional L-PRF protocol and the low-speed A-PRF protocol in terms of angiogenic potential of PRF, using an in vivo chorioallantoic membrane (CAM) assay.

MATERIAL AND METHODS: Fifteen fertile Giriraja eggs were procured and after a 3-day incubation period, randomly allotted into 3 groups: control; L-PRF; and A-PRF. A total of 20 mL of blood was collected from systemically healthy male volunteers aged 18-24 years, using a standard protocol. The PRF samples were inoculated on the CAM of the eggs. On the 10th day, the eggs were reopened and photographed. The parameters assessed were the number, length, size, and density of blood vessels, as well as the number of junctions formed. The photographs were analyzed using the ImageJ and ProgRes® CapturePro software.

RESULTS: Seven days after inoculation, both the A-PRF and L-PRF groups exhibited significantly better results than the control group in terms of the number (59.20 ±6.61 vs. 48.80 ±5.07 vs. 19.20 ±6.98), length (25,000 ±1,813.10 μm vs. 17,000 ±282.90 μm vs. 8,000 ±184.49 μm), size (230,000 ±15,054.00 μm2 vs. 200,000 ±8,295.27 μm2 vs. 150,000 ±4,105.16 μm2), and density (central: 9,100 ±296.78 vs. 5,370 ±272.42 vs. 1,420 ±564.36; peripheral: 9,094 ±400.14 vs. 3,370 ±479.39 vs. 5,420 ±746.73) of blood vessels, as well as the number of junctions formed (52 ±3.81 vs. 41 ±1.58 vs. 33 ±4.64), respectively.

CONCLUSIONS: The angiogenic potential was increased by the exposure to both L-PRF and A-PRF. However, A-PRF demonstrated statistically significant benefits in terms of the number, length, size, and density of blood vessels, as well as the number of junctions formed in comparison with the control and L-PRF groups.

PMID:38415389 | DOI:10.17219/dmp/150655

Dent Med Probl. 2024 Jan-Feb;61(1):65-70. doi: 10.17219/dmp/133072.

ABSTRACT

BACKGROUND: Immediate implant placement in the maxillary esthetic zone is a challenging and demanding task. To achieve favorable results, proper case selection and treatment planning are necessary. Variables like the sagittal root position (SRP) and the labial bone thickness (LBT) of maxillary anterior teeth are of paramount importance for predictable outcomes.

OBJECTIVES: The aim of the present study was to evaluate the SRP and LBT of maxillary anterior teeth in the context of immediate implant placement by using cone-beam computed tomography (CBCT) in a sample of the Pakistani population.

MATERIAL AND METHODS: A cross-sectional study was conducted using the CBCT scans of patients. The SRP of each tooth (maxillary canine to canine) was evaluated in the sagittal section of a CBCT scan according to the classification by Kan et al. The LBT of each tooth was measured perpendicularly to the long axis of tooth at 3 sites: at the alveolar crest (P1); 2 mm from the alveolar crest (P2); and 4 mm from the alveolar crest (P3). Descriptive statistics were reported for SRP and LBT. The χ2 test was employed to assess any association between the variables.

RESULTS: Class I SRP was the most prevalent (n = 196, 81.7%), while Class III was the least frequent (n = 1, 0.4%). The association between the tooth type and SRP was statistically non-significant (p = 0.510).

CONCLUSIONS: In the evaluated sample of the Pakistani population, the most frequent type of the SRP of maxillary anterior teeth was Class I, which is most favorable for immediate implant placement. Furthermore, the labial bone in the maxillary esthetic zone was found to be mostly thin – LBT was within the range of 0.5-0.9 mm – which makes immediate implant placement in the anterior maxilla a challenge. The results of the present study could serve as a guide for clinicians in terms of appropriate patient selection for immediate implant placement in the maxillary esthetic zone.

PMID:38415388 | DOI:10.17219/dmp/133072

Dent Med Probl. 2024 Jan-Feb;61(1):71-76. doi: 10.17219/dmp/146663.

ABSTRACT

BACKGROUND: Porosity is a crucial parameter that affects the solubility, sealing and mechanical strength of a material. It plays a significant role in determining the success of treatment.

OBJECTIVES: The present study aimed to evaluate and compare the porosity of different bioceramic-based materials, using micro-computed tomography (micro-CT).

MATERIAL AND METHODS: In the study, 76 permanent lower first or second molars that had been extracted for periodontal reasons and were free of calcification, resorption, root cavities, fractures, or cracks, with discrete roots and complete root apex development were selected. In each of the 4 experimental groups, perforations were made in the furcation areas of 19 molars. Mineral trioxide aggregate (MTA) Angelus®, EndoSequence® Root Repair Material (ERRM), Biodentine™, and BioAggregate were placed on the perforated areas of the samples and scanned with a micro-CT to evaluate porosity. The pore volume and the pore percentage with regard to the closed, open and total porosity of these repair materials were calculated individually in each sample.

RESULTS: While no statistically significant differences were found between group I (MTA), group III (Biodentine) and group IV (BioAggregate) when evaluating the total pore percentage (p > 0.05), the parameter in group II (ERRM) was found to be significantly lower as compared to other groups (p > 0.05).

CONCLUSIONS: In comparison with the other materials used in this study, the use of ERRM may be more suitable for perforation repair.

PMID:38415383 | DOI:10.17219/dmp/146663