J Thorac Oncol. 2023 Mar;18(3):271-277. doi: 10.1016/j.jtho.2022.11.023.
NO ABSTRACT
PMID:36842812 | DOI:10.1016/j.jtho.2022.11.023
Category: Nevin Manimala
Radiologia (Engl Ed). 2023 Jan-Feb;65(1):22-31. doi: 10.1016/j.rxeng.2020.09.007. Epub 2022 Jun 2.
ABSTRACT
INTRODUCTION AND OBJECTIVES: Thyroid nodules frequently require ultrasound and Fine Needle Aspiration Cytology (FNAC) evaluation. However, FNA cytology does not allow differentiation between follicular adenoma and carcinoma on Bethesda type IV lesions. This situation leads to many unnecessary surgical procedures because it is not possible to assure the benignity of the lesions, even when most of the specimens correspond to adenomas or even other benign lesions. The objective is this study is to establish if there are any US characteristics that would help us to predict the risk of malignancy of nodules with a pathological diagnosis of follicular neoplasm in order to achieve a more conservative management for non-suspicious nodules.
MATERIAL AND METHODS: We studied 61 nodules in 61 patients (51 women and 10 men) that underwent thyroid surgery and had histopathological results of either follicular adenoma or carcinoma. Different US characteristics of the nodules were analysed (composition, echogenicity, margin, calcification status, the presence of halo and overall observer suspicion of malignancy) and were correlated with the histopathological analysis.
RESULTS: We have found a statistically significant association between the presence of calcifications, ill-defined borders and overall observer suspicion or impression (defined by well-known suspicious for malignancy ultrasonographic features, such as calcification, poorly defined margin, and a markedly hypoechoic solid nodule; and benign ultrasonographic features, such as predominantly cystic echogenic composition and the presence of a perinodular hypoechogenic halo) with follicular carcinoma. However all those features have shown low sensitivities in the present study (30%, 30% and 50%, respectively). On the other hand, the absence of halo sign has shown a sensitivity of 100% and a negative predictive value (NPV) of 100% in our study.
CONCLUSIONS: The presence of calcifications, ill-defined borders and the overall impression or suspicion of malignancy associate with a higher risk for follicular carcinoma in Bethesda type IV thyroid nodules but their absence do not allow to predict benignity in these nodules. Inversely, when a halo sign lesion is observed, benign follicular neoplasm should be considered.
PMID:36842782 | DOI:10.1016/j.rxeng.2020.09.007
Med Eng Phys. 2023 Feb;112:103949. doi: 10.1016/j.medengphy.2023.103949. Epub 2023 Jan 4.
ABSTRACT
Schizophrenia (SZ) is a chronic disorder affecting the functioning of the brain. It can lead to irrational behaviour amongst the patients suffering from this disease. A low-cost diagnostic needs to be developed for SZ so that timely treatment can be provided to the patients. In this work, we propose an accurate and easy-to-implement system to detect SZ using electroencephalogram (EEG) signals. The signal is divided into sub-band components by a Fourier-based technique that can be implemented in real-time using fast Fourier transform. Thereafter, statistical features are computed from these components. Further, look ahead pattern (LAP) is developed as a feature to capture local variations in the EEG signal. The fusion of these two distinct schemes enables a thorough examination of EEG signals. Kruskal-Wallis test is utilized for the selection of significant features. Various machine learning classifiers are employed and the proposed framework achieves 98.62% and 99.24% accuracy in identifying SZ cases, considering two distinct datasets, using boosted trees classifier. This method provides a promising candidate for widespread deployment in efficient real-time systems for SZ detection.
PMID:36842772 | DOI:10.1016/j.medengphy.2023.103949
Otolaryngol Head Neck Surg. 2023 Feb 26. doi: 10.1002/ohn.168. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate the incidence rate of postextubation dysphagia (PED) in patients with COVID-19, as well as relative factors potentially influencing the clinical course of dysphagia.
DATA SOURCES: Six databases including PubMed, MEDLINE, Embase, ScienceDirect, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched with no restriction on the language.
REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were extracted and cross-examined among 3 of the authors. The random-effects model was adopted for the statistical synthesis. The percentage and 95% confidence interval (CI) were adopted as the effect measurements of the PED incidence rate. Subgroup analyses, sensitivity analyses, and metaregression were also performed to identify the heterogeneity among the studies.
RESULTS: A total of 594 patients were enrolled and analyzed from the 10 eligible studies. The weighted incidence of PED in patients with COVID-19 was 66.5% (95% CI: 49.7%-79.9%). Age was the potential factor influencing the incidence rate after heterogeneity was adjusted by the metaregression analysis.
CONCLUSION: Compared to the current evidence reporting only 41% of the non-COVID patients experienced PED, our study further disclosed that a higher 66.5% of COVID-19 patients suffered from PED, which deserves global physicians’ attention. With the association between COVID-19 and dysphagia having been more clearly understood, future clinicians are suggested to identify intubated patients’ risk factors earlier to strengthen PED care programs in the era of COVID-19.
PMID:36842159 | DOI:10.1002/ohn.168
Bull Math Biol. 2023 Feb 26;85(4):26. doi: 10.1007/s11538-023-01132-9.
NO ABSTRACT
PMID:36842144 | DOI:10.1007/s11538-023-01132-9
Probl Endokrinol (Mosk). 2023 Feb 25;69(1):59-67. doi: 10.14341/probl13141.
ABSTRACT
BACKGROUND: Gonadotropin therapy in boys with congenital isolated hypogonadotropic hypogonadism helps to increase testes volume and induce spermatogenesis in comparison with testosterone therapy. However, difficulties with dose titration, partial therapy success, absence of generally accepted regimen protocols don’t allow to use this therapy in order to induce puberty in adolescents with Kallmann syndrome or normosmic hypogonadotropic hypogonadism.
AIM: To assess the effectiveness of combination hormonal replacement therapy via human chorionic gonadotropin and recombinant follicle stimulation hormone in adolescents with congenital isolated normosmic hypogonadotropic hypogonadism and with Kallmann syndromeMATERIALS AND METHODS: This is an open single-center prospective non-controlled study. Boys with hypogonadotropic hypogonadism were receiving hormonal replacement therapy for 12 months. Initial dose of human chorionic gonadotropin was 500 IU per week. Initial dose of recombinant follicle stimulation hormone was 37.5 IU per week. Doses were doubled in 6 months. Antropometric data, Tanner stage, testes volumes, inhibin B and anti-Mullerian hormone (AMH) levels were evaluated in all the patients before the treatment, after 6 and 12 months of the therapy.
RESULTS: 8 boys with hypogonadotropic hypogonadism were included into the study. Median age before therapy initiation was 15.7 years [15.33; 16.41]. In 12 months after the therapy initiation puberty development, testosterone increase from 0.44 [0.34;0.62] to 4.39 [0.88;10.51] nmol/l (p=0.012), AMH decrease from 35.70 [18.00;59.00] to 14.41 [11.60;16.65] ng/ml were noted in all the patients (p=0.017). Testes volumes increase and inhibin B level increase were not statistically significant.
CONCLUSION: Gonadotropin therapy is effective in order to puberty initiation in adolescents with congenital hypogonadotropic hypogonadism. In helps to achieve not only androgenization, but also to Sertoli cells maturation.
PMID:36842078 | DOI:10.14341/probl13141
Gerontologist. 2023 Feb 26:gnad018. doi: 10.1093/geront/gnad018. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVES: Alzheimer’s disease or related dementia are a major cause of death in the United States. While effective interventions have been developed to deliver palliative care to nursing home residents with ADRD, little work has identified effective interventions to reach assisted living (AL) residents with dementia.
RESEARCH DESIGN AND METHODS: 118 AL residents with dementia from 10 different ALs in Florida participated. A pilot study using a cluster-randomized trial was conducted, with six sites randomized to receive a palliative care educational intervention for staff (N =23) to deliver care to residents; four sites were usual care. The feasibility of the intervention was assessed by examining recruitment, retention and treatment fidelity at 6 months. Cohen’s d statistic was used to calculate facility level treatment effect sizes on key outcomes (documentation of advance care planning discussions, hospice admission, and documentation of pain screening).
RESULTS: The intervention proved feasible with high ratings of treatment fidelity. The intervention also demonstrated preliminary evidence for efficacy of the intervention, with effect sizes for the treatment group over .80 for increases in documentation of ACP discussions compared to the control group. Hospice admissions had a smaller effect size (.16) and documentation of pain screenings had no effect.
DISCUSSION AND IMPLICATIONS: The pilot results suggest that the intervention shows promise as a resource for educating and empowering AL staff on implementing person-centered palliative care delivery to persons with dementia in assisted living. a larger, fully powered randomized trial Is needed to test for its efficacy.
PMID:36842068 | DOI:10.1093/geront/gnad018
J Pak Med Assoc. 2023 Jan;73(1):222-224. doi: 10.47391/JPMA.6450.
ABSTRACT
A quasi-experimental study was conducted at the Aga Khan University, Karachi, Pakistan, to evaluate the outcomes of a series of workshops on 25 medical students’ statistical knowledge and acceptance of RStudio. The knowledge in each of the five sessions was assessed using pre- and post- knowledge-based quizzes. In addition, the Student’s Attitude Towards Statistics (SATS-36) and the Technology Acceptance Model were used. Data analysis on RStudio revealed a statistically significant improvement in knowledge in all five sessions (p<0.05). SATS-36 showed statistically significant improvement in Cognitive Competence (p<0.001). RStudio had commendable acceptance with relatively high scores of Attitudes (behavioural intention, median = 6.00 [5.20-7.00]) and Utility (perceived usefulness, median = 5.20 [4.10-6.20]). In conclusion, medical students had improved statistical knowledge and acceptance towards the novel statistical tool. Hence, further studies must evaluate the effectiveness of RStudio when integrated as part of the medical curriculum.
PMID:36842055 | DOI:10.47391/JPMA.6450
J Pak Med Assoc. 2023 Jan;73(1):157-161. doi: 10.47391/JPMA.2075.
ABSTRACT
Bone defect assessment in primary advanced knee arthritis can present a challenge for the surgeon and lead to unfavourable outcomes if not adequately determined during preoperative planning. The aim of this study was to introduce a new, simple and quick way to assess and quantify bone defect using short film radiographs and utilising it to choose the total knee prosthesis. This is a prospective case series of patients who underwent TKA (Total Knee Arthroplasty) using various types of prostheses. Three different angles – Tibiofemoral angle, MPTA (medial proximal tibial angle), and JLCA (joint line convergence angle) – were measured preoperatively to evaluate limb alignment, placement of the tibial, and femoral components of total knee prosthesis. Postoperatively roentgenographic index introduced by Lotke et al was used to assess our preoperative methodology. The American knee society score was used pre- and postoperatively up to one year. A total of eight knees of six patients were analysed (four males, two females). The mean age of the patients was 57.75±5.701 years. All the knees were in varying degrees of varus deformity preoperatively. The accuracy of the preoperatively used radiological angles was analysed by postoperative measurement of tibiofemoral angle (d), tibial anatomical axis (b) and femoral anatomical axis (a), and Roentgenographic index as suggested by Lotke et al. Postoperatively, all the knees were in valgus with tibiofemoral angle (d) 6.50±0.926, tibial component alignment (b) mean was 89±1.195, and femoral component alignment (a) mean was 5.13±0.991 valgus. Mean roentgenographic index was 89.38±3.292. American knee society score improved at one-year follow-up postoperatively and was statistically significant with p<0.001. In this study, a new classification for bone defects in primary arthritic knees by utilising simple plain radiograph short films and as a guide for implant selection is proposed.
PMID:36842029 | DOI:10.47391/JPMA.2075
J Pak Med Assoc. 2023 Jan;73(1):129-130. doi: 10.47391/JPMA.3594.
ABSTRACT
The term temporomandibular disorder is used for pain and dysfunction at the temporomandibular joint. Manual therapy or exercise therapy has proven to be an effective measure for pain relief. The purpose of this study was to compare the effectiveness of manual therapy and exercise therapy in temporomandibular disorders. A quasi-experimental study was conducted from June 30, 2020 to December 30, 2020 in Al-Sheikh teaching hospital, Sialkot, Pakistan. A convenient sample of 24 patients was involved in the study. Lottery method was used to randomise the patients in either the Manual Therapy Group or Exercise Therapy Group. The participants were assessed before and after the intervention through Numeric Pain Rating Scale (NPRS) for pain, Patient-Specific Functional Scale (PSFS) for function, Fonesca Amnestic Index (FAI) for the severity of condition, and Millimetre Mouth Opening (MMO) for ranges. The manual therapy group showed a statistically significant difference in pre- and post-treatment NPRS, PSFS, FAI and MMO (p< 0.0001). Manual physical therapy is more effective to improve pain, ROM, function, and severity in temporomandibular disorders.
PMID:36842021 | DOI:10.47391/JPMA.3594