Category: Nevin Manimala

J Chromatogr B Analyt Technol Biomed Life Sci. 2022 Feb 28;1195:123200. doi: 10.1016/j.jchromb.2022.123200. Online ahead of print.

ABSTRACT

Untargeted lipidomics using liquid chromatography high-resolution mass spectrometry (LC-HRMS) was performed using polarity switching, and in positive and negative polarity separately on the same set of serum samples, and the performances of the methods were evaluated. Polarity switching causes an increase in the cycle time of the HRMS measurements (1.18 s/cycle vs 0.27 s/cycle), resulting in fewer data points across chromatographic peaks. The coefficient of variation (CV) was on average lower for the added isotopically labelled standards in pooled samples (QC) and patient samples using separate polarities (QC = 5.6%, samples = 12.5%) compared to polarity switching (QC = 8.5%, samples = 13.4%), but the difference was not statistically significant. For the endogenous features measured in the QCs polarity switching resulted in on average significantly higher CVs (3.80 (p = 4.25e-30) and 3.3 percentage points (p = 6.84e-40), for positive and negative modes, respectively) however still acceptable for an untargeted method (mean CVs of 17.9% and 12.2% in positive and negative modes respectively). A slightly larger number of endogenous features were detected using the separate polarities, but the large majority of features (>95%) were detected with both methodologies. The overlap of features detected in both positive and negative polarities was low (4.1%) demonstrating the importance of using both polarities for untargeted lipidomics. When investigating the effects of a treatment on multiple sclerosis patients it was found that both methodologies gave highly similar biological results, further confirming the applicability of polarity switching.

PMID:35247679 | DOI:10.1016/j.jchromb.2022.123200

Ultrason Sonochem. 2022 Mar 1;84:105966. doi: 10.1016/j.ultsonch.2022.105966. Online ahead of print.

ABSTRACT

Ultrasound assisted aqueous two-phase extraction of polysaccharides from Cornus officinalis fruit was modeled by response surface methodology (RSM) and artificial neural network (ANN), and optimized using genetic algorithm coupled with ANN (GA-ANN). Statistical analysis showed that the models obtained by RSM and ANN could accurately predict the Cornus officinalis polysaccharides (COPs) yield. However, ANN prediction was more accurate than RSM. The optimum extraction parameters to achieve the highest COPs yield (7.85 ± 0.09)% was obtained at the ultrasound power of 350 W, extraction temperature of 51 ℃, liquid-to-solid ratio of 17 mL/g, and extraction time of 38 min. Subsequently, the crude COPs were further purified via DEAE-52 and Sephadex G-100 chromatography to obtain a homogenous fraction (COPs-4-SG, 33.64 kDa) that contained galacturonic acid, arabinose, mannose, glucose, and galactose in a molar ratio of 34.82:14.19:6.75:13.48:12.26. The structure of COPs-4-SG was also characterized with UV-vis, fourier-transform infrared spectroscopy (FT-IR), atomic force microscopy (AFM), scanning electron microscopy (SEM), Congo-red test, and circular dichroism (CD). The findings provide a feasible way for the extraction, purification, and optimization of polysaccharides from plant resources.

PMID:35247682 | DOI:10.1016/j.ultsonch.2022.105966

Vision Res. 2022 Mar 2;196:108028. doi: 10.1016/j.visres.2022.108028. Online ahead of print.

ABSTRACT

In conventional psychophysical reverse correlation methods using white or pink noise, the luminance noise is added to every pixel. Thus, the image features correlated with perception are often biased toward local mean luminance. Furthermore, spatial frequencies and orientations are represented in the primary visual cortex, which forms the basis of various visual perception. In this study, we proposed a new reverse correlation method using noise that modulated the spatial frequency sub-band contrast and examined its properties in psychophysical experiments on facial skin lightness perception. In the experiment, we asked the observers to compare the perceived skin lightness in a paired comparison manner on face stimuli with increased or decreased spatial frequency sub-band contrasts at random spatial locations. The results showed that the contrasts in the eyes or irises were strongly and positively correlated with the perceived skin lightness in most sub-bands, demonstrating that the proposed method reiterated the findings of previous studies that the sparkle of the irises makes the skin appear lighter. Contrarily, the conventional reverse correlation method using pink noise images was applied to the skin lightness perception. The results indicated that only the local mean luminance in some skin regions, such as the forehead, was correlated with skin lightness perception. In summary, with the proposed method, we found some image features in the facial parts other than the skin mean luminance relevant to skin lightness perception, which are difficult to detect using the conventional method. They are considered complementary given that the proposed method and the conventional method extracted considerably different image features. It depends on the psychophysical tasks and stimuli which one is more appropriate.

PMID:35247671 | DOI:10.1016/j.visres.2022.108028

Anaesth Crit Care Pain Med. 2022 Mar 2:101053. doi: 10.1016/j.accpm.2022.101053. Online ahead of print.

NO ABSTRACT

PMID:35247639 | DOI:10.1016/j.accpm.2022.101053

J Allergy Clin Immunol Pract. 2022 Mar 2:S2213-2198(22)00219-7. doi: 10.1016/j.jaip.2022.02.018. Online ahead of print.

ABSTRACT

BACKGROUND: Skin diseases associated with blood or tissue eosinophilia are common. As their clinical manifestations are various, making the correct diagnosis can be challenging. So far, dermatological patients with concomitant blood eosinophilia have not been characterized.

OBJECTIVE: We aimed at investigating patterns of dermatological patients with concomitant blood eosinophilia in order to obtain information helpful for optimizing disease management.

METHODS: In this retrospective study, demographic and clinical data and diagnostic test results of all patients presenting with dermatoses associated with blood eosinophilia (DABE) referred to a university center from 2014 to 2018 were extracted from the electronic patient charts and evaluated using descriptive and semantic map analyses.

RESULTS: A total of 453 patients (51.4% females; mean age 58.4 ±21.7 years) were included and grouped according to blood absolute eosinophil counts: severe, ≥1.5 G/L (n=87; 19.2%), moderate, 1.0 – 1.49 G/L (n=73; 16.1%), and mild eosinophilia, 0.5 – 0.99 G/L (n=293; 64.7%). Most patients presented with chronic (64.6%), generalized skin lesions (75.9%), and pruritus (88.1%). Statistical analyses revealed three distinct patterns: 1. mild eosinophilia associated with localized skin disease, age <50 years, history of atopy, diagnosis of eczema or infectious disease, 2. moderate eosinophilia linked to generalized skin lesions, pruritus, age > 70 years, and autoimmune bullous disease, and 3. severe eosinophilia associated with diagnosis of hypereosinophilic syndromes, drug hypersensitivity or malignant disesase.

CONCLUSIONS: Based on the pattern analysis of patients with DABE, a diagnostic workup has been developed aiming at setting the correct differential diagnosis in a feasible and effective manner.

PMID:35247633 | DOI:10.1016/j.jaip.2022.02.018

World Neurosurg. 2022 Mar 2:S1878-8750(22)00260-1. doi: 10.1016/j.wneu.2022.02.113. Online ahead of print.

ABSTRACT

OBJECTIVE: The National Inpatient Sample – the largest all-payer inpatient database in the United States – is an important instrument for big data analysis of neurosurgical inquiries. However, earlier research has determined that many NIS studies are limited by common methodological pitfalls. In this study, we provide the first primer of NIS methodological procedures in the setting of neurosurgical research and review all published neurosurgical studies utilizing the NIS.

METHODS: We designed a protocol for neurosurgical big data research using the NIS, based on the authors’ subject matter expertise, NIS documentation, and input and verification from the Healthcare Cost and Utilization Project. We subsequently used a comprehensive search strategy to identify all neurosurgical studies utilizing the NIS in the PubMed and MEDLINE, Embase, and Web of Science databases from inception to August 2021. Studies underwent qualitative categorization (years of the NIS studied, neurosurgical subspecialty, age group, and thematic focus of study objective) and analysis of longitudinal trends.

RESULTS: We identified a canonical, four-step protocol for NIS analysis: study population selection, defining additional clinical variables, identification and coding of outcomes, and statistical analysis. Methodological nuances discussed include identifying neurosurgery-specific admissions, addressing missing data, calculating additional severity and hospital-specific metrics, coding perioperative complications, and applying survey weights to make nationwide estimates. Inherent database limitations and common pitfalls of NIS studies discussed include lack of disease process-specific variables and data following the index admission, inability to calculate certain hospital-specific variables after 2011, performing state-level analyses, conflating hospitalization charges and costs, and not following proper statistical methodology for performing survey-weighted regression. In a systematic review, we identified 647 neurosurgical studies utilizing the NIS. While almost 60% of studies were published after 2015, <10% of studies analyzed NIS data after 2015. The average sample size of studies was 507,352 patients (standard deviation=2,739,900). Most studies analyzed cranial procedures (58.1%) and adults (68.1%). The most prevalent topic areas analyzed were surgical outcome trends (35.7%) and health policy and economics (17.8%), while patient disparities (9.4%) and surgeon or hospital volume (6.6%) were the least studied.

CONCLUSIONS: We present a standardized methodology to analyze the NIS, systematically review the state of the NIS neurosurgical literature, suggest potential future directions for neurosurgical big data inquiries, and outline recommendations to improve the design of future neurosurgical data instruments.

PMID:35247618 | DOI:10.1016/j.wneu.2022.02.113

World Neurosurg. 2022 Mar 2:S1878-8750(22)00265-0. doi: 10.1016/j.wneu.2022.02.118. Online ahead of print.

ABSTRACT

OBJECTIVE: Preoperative embolization for intracranial meningiomas can cause tumor necrosis, reduce intraoperative blood loss, and facilitate surgery. This study aimed to evaluate the efficacy of tumor embolization using Embosphere® microspheres for skull base meningiomas and analyze post-embolization plain computed tomography (CT) and magnetic resonance imaging (MRI) scans to identify findings that could potentially predict treatment response.

METHODS: Between April 2014 and April 2020, 80 patients with skull base meningiomas presenting at our medical center underwent embolization with Embosphere® microspheres. The effects of tumor embolization were evaluated through a comparison of post-embolization plain CT and contrast-enhanced MRI.

RESULTS: A total of 143 vessels (102/108 external carotid artery branches; 41/65 internal carotid artery branches) from 80 skull base meningiomas were embolized with Embosphere® microspheres. Microspheres 100-300 μm in size were used in two cases, microspheres 300-500 μm in size were used in 12 cases, and microspheres 500-700 μm in size were used in 66 cases. Post-embolization contrast-enhanced MRI showed reductions in enhancing lesions within the tumor in 55/80 cases. Post-embolization plain CT scans showed high-density lesions within the tumor in 41/55 cases. Thus, reductions in enhancing lesions on post-embolization contrast-enhanced MRI were statistically significantly associated with the presence of high-density lesions on post-embolization plain CT (P<0.001). Embolization-related neurological complications occurred in three cases.

CONCLUSIONS: Embosphere® microspheres are user friendly and effective embolic materials for the embolization of skull base meningiomas. Post-embolization contrast-enhanced MRI and plain CT findings may be useful for evaluating the effects of tumor embolization.

PMID:35247619 | DOI:10.1016/j.wneu.2022.02.118

Acta Chir Orthop Traumatol Cech. 2022;89(1):68-74.

ABSTRACT

PURPOSE OF THE STUDY Exploring the therapeutic potential of pathological fractures treatment of the proximal femur in childhood with LCP paediatric hip plate system according to the principles of AO. MATERIAL AND METHODS Six children with pathological fractures of the proximal femur and with an unicameral bone cyst have undergone surgery in our institution, in the period between June 2018 up until December 2020. All patients were young boys with a mean age of 11.83 ± 3.43 years. According to the classification of Delbet-Colonna, three of the fractures were Type IV – intertrochanteric fractures and three were Type III – basocervical fractures. ccording to the AO Trauma classification, one of the fractures was complete transtrochanteric multifragmentary (31-M/3.2.III), two were complete transtrochanteric simple (31-M/3.1.III), one was Complete basocervical multifragmentary (31-M/3.2.II) and two were complete basicervical simple (31-M/3.1.II). All patients have undergone open reposition and osteosynthesis with a 130° LCP pediatric hip plate system (DePuy Synthes Pediatric LCP Plate System). In four of the patients, one or two of the proximal locking screws pass through the growth plate, to ensure more stability. The anatomical correction of the proximal femur has been measured through the cervico-diaphyseal angle, consolidation of the fracture, the spontaneous reparation of the cyst according to the Capanna classification and cystic index, presence of avascular necrosis of the epiphysis, shortening of the extremity, and functional grading by the Musculoskeletal Tumor Society (MSTS) staging system. The Mann-Whitney (Wilcoxon W) test was used for data processing. RESULTS The mean timing of the follow-up after the surgery was 22 months (range 6-32). A radiographically supported consolidation of the fracture has occurred at an average timing of 4.8 months (range 3-6) in all patients. There is no clinical or radiological evidence of postoperative avascular necrosis in any of the patients. According to the classification of Capanna, in five of the six patients a spontaneous reparation of the cyst has occurred. In one of the cases, the reparation is classified as grade II with a pathological cystic index of 2.27. A postoperative correction of the varus fracture deformity of the proximal femur has been achieved in all children. The cervical-diaphysary angle of 112.50° preoperatively has been corrected to 137.17° (p=0.002). The achieved correction is lasting and the average value of the CDS at the final follow-up is 138.17° (p=0.794). Intraoperative correction, statistically equal to the CDA of the healthy side (p=0.942) is achieved with this operative technique. Data from the MSTS show functional correction on the third postoperative month with 38.33% of the norm (p=0.002) and 85% on the final follow-up (p=0.002). A contralateral distal femoral surgical epiphysiodesis by the method of Métaizeau has been used for the correction of the difference in the length of the extremities (with an average of 2.9 cm). CONCLUSIONS Osteosynthesis with an LCP paediatric hip plate system gives the opportunity for anatomical correction of the proximal femur with a low risk of avascular necrosis and achieving optimal functional results in pathological basocervical and intertrochanteric fractures in childhood. The use of 5mm plates and penetration of the proximal screw through the growth plate holds an increased risk of growth disruption. Key words: LCP paediatric hip plate system, pathological fracture, unicameral bone cysts, proximal femur.

PMID:35247247

Acta Chir Orthop Traumatol Cech. 2022;89(1):43-47.

ABSTRACT

PURPOSE OF THE STUDY The aim of this retrospective study was to assess the subjective evaluation of treatment by patients with respect to their return to work and recreational sport following the fracture of clavicle diaphysis with posttraumatic shortening of 1.5 cm, or more, treated non-operatively and surgically. MATERIAL AND METHODS Our group of patients consisted of 51 patients (14 females, 37 males) aged between 18 and 89 years (average age 46 years). We concentrated on the parameters of sex, age, side of injury, extent of posttraumatic shortening, method of treatment, return to work or recreational sport, DASH score at one year post non-operative or surgical treatment. Patients who sustained a pathological fracture, fractures of the clavicle combined with an injury of the acromioclavicular joint or simultaneous fracture of the humerus or the ribs were excluded from the study. Patients with open fractures or re-fractures were excluded as well. The indication for treatment selection was based on pre-operative discussion of the doctor with the patient and the Informed Consent was signed. The patient was informed about different treatment options. A shorter period of fixation of the arm and post-operative physiotherapy was mentioned in connection with surgical treatment as well as potential surgical complications. A statistical analysis comparing the data in both groups was conducted using the Fisher exact test. The p-value of 0.05 or less was considered as statistically significant. RESULTS The right side was affected 26 times, the left side 25 times. The shortening ranged from 1.5 to 3.7 cm. 24 patients (8 females, 16 males) aged 21 to 89 years (average 54 years) were treated non-operatively. 27 patients (6 females, 21 males) aged 18 to 74 years (average 38 years) underwent surgery. The difference in sex distribution in both groups was not statistically significant (p = 0.5311). According to the Robinson classification, there were 17 patients with type 2A2 fractures, of whom 8 underwent surgery and 9 were treated non-operatively, 19 patients with type 2B1 fractures, of whom 9 underwent surgery and 10 were treated non-operatively, and 15 patients with type 2B2, of whom 10 underwent surgery and 5 were treated non-operatively. The surgically treated patients prevailed in type 2B2 only, but this difference was not statistically significant (p = 0.2350). In the non-operatively treated group, 23 out of 24 patients returned to pre-injury activities in 3 months on average. Ten patients (48%) reported reaching the same function as on the other side. In the DASH score evaluation, 11 patients reached the value of 0-3.3, five patients 3.4-10, six patients 10.1-30.0 and two reached the score of more than 30. In the evaluation of capacity to work, 15 out of 24 patients were able to work, 11 of them without any restrictions or difficulties. In the evaluation of the sport and playing musical instrument module, 9 out of 24 patients did not engage in sports activities or do not play any musical instruments. In the surgically treated group, 26 out of 27 patients returned to pre-injury activities within 6 weeks. 19 (70%) patients reported reaching the same function as on the other side. In the DASH score evaluation, 19 patients reached the value of 0-3.3, two patients 3.4-10, 5 patients 10.1-30.0 and one patient with nonunion 72.5. Comparison of the average values of the DASH score demonstrated slightly better results achieved by surgical treatment (9.03 vs 6.77). When assessing the work module, 24 out of 27 patients returned to work, 20 of them without any restrictions or difficulties. Out of 27 patients, 4 patients were no longer able to engage in sports activities or to play a musical instrument. Of the 23 remaining patients, 18 did not have any problems, 5 suffered from minimal problems. The group of patients treated non-operatively included one case of non-union and the same applies to the surgically treated group. In 3 patients the removal of hardware was performed, 3 patients underwent revision of the surgical wound because of infection. DISCUSSION The recommendation of the weight-bearing of the upper extremity was similar in both groups, 12 weeks post injury/surgery on average. It is clear that sooner return to work or sports activities in the surgically treated group was preferred by younger patients who expected quicker recovery. Younger patients were less patient and more eager to return to work and sports, while the older patients, on the other hand, were more cautious about possible complications of surgery. CONCLUSIONS The results of our study did not identify any correlation between the clavicle shortening and the indication for surgical treatment. Surgical treatment was preferred by younger patients, more frequently by males. The rationale was supported by the perspective of sooner return to work and favourite sports activities. Their decision was not affected by the known risks of surgical treatment. Evaluation of the DASH score at one year after injury/surgery showed similar results. A higher incidence of complications in the surgically treated group did not lead to negative evaluation of the selected treatment modality by the highly motivated group of patients either. Key words: fractures of the clavicle diaphysis, non-operative treatment, surgical treatment, return to work, return to sports activities, functional results at 1 year.

PMID:35247243

Acta Chir Orthop Traumatol Cech. 2022;89(1):48-52.

ABSTRACT

PURPOSE OF THE STUDY Hemoglobin (Hb) levels tend to decrease in patients after hip fractures. There are several factors that is responsible for this decrease in Hb levels. The primary aim in this study was to evaluate the risk factors of blood loss in patients with IFF and to determine the limits that may require allogeneic blood transfusion (ABT), and the secondary aim was to prevent unnecessary blood crossing outside these limits. MATERIAL AND METHODS 119 patients with intertrochanteric femur fracture (IFF) were included in the study. The patients were divided into two groups according to the use of ABT in the postoperative period. Age, gender, fracture side, height, weight, body mass index (BMI), American Society of Anesthesiologist (ASA) score, preoperative hemoglobin (Hb) level, platelet (Plt) number, International Normalized Ratio (INR), prothrombin time (PT), activated partial thromboplastin time (aPTT) values, comorbid diseases, history of drug use, whether ABT was applied in the preoperative period or not, and the postoperative 1st day Hb levels were evaluated from the medical records. A p value below than 0.05 was accepted as statistically significant. RESULTS Advanced age [odds ratio (OR) 1.069, 95% confidence interval (CI) 0.372-3.202], unstable fracture type [OR 0.258, 95% CI 0.496-6.632], and hemoglobin level <11 g / dL [OR 5.574, 95% GA 0.312-65.278 was found to be an independent predictive risk factor for allogeneic blood transfusion requirement in the postoperative period. DISCUSSION There are several factors that is responsible for decrease in Hb levels in patients after hip fractures. The most important and most likely cause of these is the fracture itself. Other reasons are stated as type of fracture, time elapsed until the surgical treatment, preferred implants for treatment, advanced age, mean preoperative Hb value and anticoagulant drug usage in literature. Although the preoperative blood loss due to trauma is inevitable, unnecessary aggressive and/or inadequate treatments can be avoided if patients with higher bleeding risk and complication rate can be detected. CONCLUSIONS Advanced age, unstable fracture pattern and low preoperative Hb values should be considered as risk factors for the postoperative ABT requirements for patients with IFF. Key words: intertrochanteric femur fracture, allogenic blood transfusion, blood loss hemoglobin level.

PMID:35247244