Category: Statistics

Orthop Surg. 2023 Sep 7. doi: 10.1111/os.13843. Online ahead of print.

ABSTRACT

STUDY DESIGN: Single-center, retrospective study.

OBJECTIVE: Hemivertebra resection is the only treatment option for congenital cervical scoliosis (CCS). However, this procedure is complex and technically demanding. It often requires a considerably long operation, and there is substantial intraoperative bleeding. Therefore, we have attempted to treat CCS with a concave side distraction comprising a three-dimensional (3D) printed titanium cage. The purpose of this study is to evaluate the safety and efficacy of this technique for the treatment of patients with CCS.

METHODS: A series of 22 patients with CCS who underwent a concave side distraction technique between 2019 and 2021 were retrospectively reviewed and analyzed. Radiological measurements included the Cobb angle of the distraction segments, the kyphosis angle, the range of movement, and the distraction correction angle. Student’s t-test and Spearman correlation analysis were used for statistical analysis. p < 0.05 was considered statistically significant.

RESULTS: The study included 12 males and 10 females whose ages ranged from 6 to 14 years old (9.8 ± 2.1 years old). Follow-up times ranged from 15 to 30 months (25.8 ± 3.6 months). Among 22 patients, two patients developed a postoperative C5 nerve root palsy and recovered after being treated with conservative treatment for 6 months. The duration of surgery ranged from 229 to 756 min (389 ± 112 min), and the estimated volume of blood loss ranged from 100 to 600mL (235 ± 121 mL). The coronal Cobb angle (p < 0.001), kyphosis angle (p < 0.05), and range of movement (p < 0.001) between the last follow-up and preoperative period were significantly different. A total of 28 segments were distracted, and the Cobb angle of the distraction segment ranged from 2.4 to 14.1° (8.5 ± 3.0°). There were six upper cervical spines (8.9 ± 1.9°) and 22 lower cervical spines (8.4 ± 3.2°) with no significant difference between them (p = 0.130). In addition, there was no correlation between the angle of the concave side distraction and patients’ age (r = 0.018, p = 0.315). The fusion was solid between the bone and the customized 3D-printed pore metal cage at the final follow-up.

CONCLUSION: The concave side distraction comprising a customized 3D-printed titanium cage implantation can provide satisfactory correction results and is a safe and reliable procedure for treating CCS.

PMID:37675762 | DOI:10.1111/os.13843

Orthop Surg. 2023 Sep 7. doi: 10.1111/os.13855. Online ahead of print.

ABSTRACT

OBJECTIVE: Pelvic compensation is common in femoroacetabular impingement (FAI) patients to reduce symptoms and increase range of motion. However, little attention was given to the postoperative clinical effect of pelvic compensation. Therefore, this study aims to compare the outcomes between pelvic compensation and normal pelvic position in femoroacetabular impingement (FAI) patients after hip arthroscopy.

METHODS: The retrospective study was conducted from January 2019 to June 2022, recruited consecutive patients who were diagnosed with FAI and received subsequent arthroscopic treatment. All patients completed an X-ray in the anterior-posterior standing position before and 4 weeks after surgery. Patients with pelvic compensation were compared with those who did not. Functional outcomes included hip disability and osteoarthritis outcome score (HOOS), modified Harris (mHHS) score, and lower-extremity activity scale (LEAS). Secondary outcomes included the EuroQol Five Dimensions Questionnaire (EQ-5D) and patient satisfaction. The intraclass correlation coefficient (ICC) was used to analyze interobserver and intraobserver reliability.

RESULTS: Ninety patients with a mean age of 39.40 years were included in the study. No significant compensation changes were noted within groups after the elimination of impingement. The functional scores showed no significant difference between groups (p(HOOS) = 0.352, p(mHHS) = 0.183, p(LEAS) = 0.865). The EQ-5D revealed statistically better performance in usual activities in the compensatory group (p = 0.044). There are no significant between-group differences in patients’ satisfaction evaluations.

CONCLUSION: As assessed by Patient-Reported Outcome Measures (PROMs), patients with compensatory pelvic tilt demonstrated similar clinical outcomes without extra adverse events to patients with normal pelvic positioning in short-term follow-ups. Furthermore, compensatory pelvic tilt did not significantly enhance the range of motion or functional outcome at short-term follow-ups.

PMID:37675759 | DOI:10.1111/os.13855

Saudi J Kidney Dis Transpl. 2022 Aug;33(Supplement):S179-S183. doi: 10.4103/1319-2442.384190.

ABSTRACT

Urinary tract infection (UTI) is common in children. It is caused by bacteria and can lead to complications such as renal scarring in cases of late diagnosis and a lack of early treatment. Vesicoureteral reflux (VUR) occurs when urine flows from the bladder to the ureter and kidney, and is more common in children with UTI. VUR predisposes patients to pyelonephritis and can cause renal scarring. This retrospective study aimed to determine whether VUR was associated with the evolution to renal scarring in 132 infants aged 9 days to 24 months admitted to a tertiary care hospital in Jeddah, Saudi Arabia, with the first episode of febrile UTI (mean age = 4.48 months [standard deviation = 5.48]; 82 [62.1%] males; 50 [37.9%] females). Data from their medical records were investigated[INLINE:1]for VUR and renal scarring. The VUR was related to renal scarring (P = 0.001). C-reactive protein (CRP) levels were significantly higher in patients with VUR (P = 0.027) and renal scars (P = 0.05). There was a statistically significant difference between VUR and renal scarring with the first UTI (P = 0.001). In conclusion, our study revealed a significant association of CRP with renal scarring (P = 0.05) and VUR and (P = 0.027).

PMID:37675748 | DOI:10.4103/1319-2442.384190

Saudi J Kidney Dis Transpl. 2022 Aug;33(Supplement):S105-S110. doi: 10.4103/1319-2442.384182.

ABSTRACT

Multiple myeloma (MM) is a disease of the elderly. Renal failure is a common complication in MM. In this study, we evaluated clinical and laboratory parameters that might contribute to the recovery of renal function in geriatric MM patients. Twenty-five geriatric patients aged >65 years were retrospectively compared with 20 patients aged <65 years with a diagnosis of MM and renal failure between October 2016 and October 2019. Variables that might be associated with the discontinuation of dialysis in these patients were examined in the 6 months of follow-up after the diagnosis. Among the geriatric patients aged >65 years, 100% remained on regular hemodialysis (HD) at the end of the follow-up period in contrast to eight patients (40%) in the younger group, and this was statistically significant P = 0.001. We have noticed that geriatric patients who required maintenance HD had lower mean hemoglobin concentrations (P = 0.02), and higher mean serum calcium (P = 0.03). Other factors were statistically insignificant. Our study showed that age of >65 years, hemoglobin levels, and serum calcium were significantly different between the group who recovered from renal failure and those who required a continuation of HD, but none was an independent prognostic factor for predicting the probability of recovery from severe renal failure and discontinuation of HD in both groups studied.

PMID:37675740 | DOI:10.4103/1319-2442.384182

J Cancer Res Ther. 2023 Aug;19(4):1019-1023. doi: 10.4103/jcrt.jcrt_303_23.

ABSTRACT

OBJECTIVE: This study aimed to examine the effectiveness and safety of respiratory sensing methods in nonvascular interventional therapy of liver tumors.

MATERIALS AND METHODS: In this study, 64 patients with primary liver cancer or liver metastasis were retrospectively analyzed. According to two widely used clinical techniques to limit respiratory movement-breath holding and respiratory sensing technology-they were randomly allocated into two groups: respiratory gated and respiratory training. We aimed to compare the application and effect of these two techniques in the nonvascular interventional therapy of liver tumors.

RESULTS: The puncture times of the respiratory-gated and respiratory training groups were 5.34 ± 2.47 and 8.41 ± 3.63 min, respectively. Puncture errors were 10.00 ± 2.65 and 12.81 ± 8.57 mm, respectively. Puncture adjustment times were 3.06 ± 1.26 and 4.87 ± 1.69 times, respectively, and the differences were statistically significant (P < 0.01).

CONCLUSIONS: Respiratory sensing technology has been effectively used to assist in puncturing liver malignant tumors using a radiofrequency (RF) ablation (RFA) system that is guided by computed tomography (CT) scans. It is superior to the classical breath-holding step puncture technique in terms of puncture time, puncture error, and puncture needle adjustment times.

PMID:37675731 | DOI:10.4103/jcrt.jcrt_303_23

J Cancer Res Ther. 2023 Aug;19(4):988-994. doi: 10.4103/jcrt.jcrt_2060_22.

ABSTRACT

CONTEXT: The present experimental models of cystic diseases are not adequate and require further investigation.

AIM: In this study, a new way of producing a tissue-mimicking model of cysts and cystic neoplasms was evaluated.

SETTINGS AND DESIGN: To simulate cysts and cystic neoplasms, ex vivo rabbit normal bladders and VX2-implanted tumor bladders were produced, fixed, and embedded in agarose gel.

METHODS AND MATERIALS: The samples were classified into four groups based on tumor features and the maximal transverse diameter of the rabbit bladder, which were assessed using computer tomography (CT) imaging and statistically analyzed.

STATISTICAL ANALYSIS USED: Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software. The t-test was used for analyzing enumeration data.

RESULTS: Twenty-one rabbit bladders (21/24) were successfully removed and prepped for this experiment, comprising eleven normal bladders (11/24) and ten implanted with VX2 tumors (10/24). The gelling ingredient used to form the visualization and fixation matrix was agarose at a concentration of 4 g/200 mL. The temperature of the agarose solution was kept constant at 40-45°C, which is the optimal temperature range for ex vivo normal bladder and implanted VX2 tumor bladder insertion. The average time required to embed and fix the bladders in agarose gel was 45.0 ± 5.2 minutes per instance. The gel-fixing matrix’s strength and light transmittance were enough for building the models.

CONCLUSION: We created an experimental tissue-mimicking model of cysts and cystic neoplasms with stable physicochemical features, a safe manufacturing method, and high repeatability. These models may be used to assist with cystic lesion diagnosis and treatment techniques.

PMID:37675727 | DOI:10.4103/jcrt.jcrt_2060_22

J Cancer Res Ther. 2023 Aug;19(4):972-977. doi: 10.4103/jcrt.jcrt_2193_22.

ABSTRACT

CONTEXT: The purpose of this study was to assess computed tomography (CT)-guided puncture biopsy of pulmonary nodules at a high risk of bleeding. First, a coaxial trocar technique was used to radiofrequency ablate small blood vessels in the puncture area, followed by a biopsy of the pulmonary nodule.

AIM: This study aimed to evaluate the effectiveness and safety of this procedure.

METHODS: In this retrospective research, we assessed the relevant data of 45 patients who had undergone needle biopsy of pulmonary nodules at a high risk of bleeding. Twenty-five of these patients had CT-guided coaxial radiofrequency ablation (RFA)-assisted biopsy (group A). The remaining 20 had undergone conventional CT-guided needle biopsy (group B). We equated the technical success rate and the incidence of complications such as bleeding, pneumothorax, and pain in the two groups of needle biopsies.

RESULTS: Both groups had a 100% success rate with puncture biopsy. The incidences of pneumothorax in groups A and B were 10% (2/20) and 24% (6/25), respectively; this difference is not significant (P > 0.050). The rates of bleeding in groups A and B were 10% (2/20) and 44% (11/25), respectively, and the rates of pain were 30% (6/20) and 60% (15/25), both of which were statistically significant (P = 0.030; P = 0.045, respectively).

CONCLUSIONS: CT-guided coaxial trocar technique for RFA-assisted biopsy of pulmonary nodules at a high risk of bleeding is effective and safe and can significantly reduce the risk of biopsy-induced pulmonary hemorrhage.

PMID:37675725 | DOI:10.4103/jcrt.jcrt_2193_22

J Cancer Res Ther. 2023 Aug;19(4):924-932. doi: 10.4103/jcrt.jcrt_2296_22.

ABSTRACT

PURPOSE: To examine post-operative progression and risk impact of insufficient radiofrequency ablation (RFA) following transarterial chemoembolization (TACE) for the prognosis of large hepatocellular carcinoma (HCC).

MATERIALS AND METHODS: From January 2014 to January 2021 were analyzed. A total of 343 patients with large HCC (diameter >5 cm) who received TACE combined with RFA were enrolled and were divided into two groups: complete ablation (CA, n = 172) and insufficient ablation (IA, n = 171). Overall survival (OS) and progression-free survival (PFS) were determined by the Kaplan-Meier curve and compared with the log-rank test. To find parameters influencing OS and PFS, clinicopathological variables underwent univariate and multivariate analysis.

RESULTS: The cumulative 1-, 3-, and 5-year OS and PFS rates of the CA group were significantly higher than that of the IA group (P < 0.001). 25 (41%) patients in local tumor progression (LTP), 36 (59%) in intrahepatic distant recurrence (IDR), and 0 (0%) in extrahepatic distant recurrence (EDR) in the CA group. 51 (32.1%) patients in LTP, 96 (60.4%) patients in IDR, and 12 (7.5%) cases in EDR in the IA group. The recurrence patterns of the two groups were statistically significant difference (P = 0.039). In multivariate analysis, inadequate ablation and conjunction with TKIs were both significant risk factors for OS and PFS. Apart from these, older age and >7 cm of tumor size were indicators of poor OS and multiple tumors were indicators of poor PFS.

CONCLUSION: Insufficient ablation causes a poor survival outcome of TACE combined with RFA for large HCC, particularly, which can promote IDR.

PMID:37675718 | DOI:10.4103/jcrt.jcrt_2296_22

J Cancer Res Ther. 2023 Aug;19(4):904-909. doi: 10.4103/jcrt.jcrt_1290_22.

ABSTRACT

AIMS: To compare the diagnostic efficacy and safety of CT-guided percutaneous core needle biopsy (CNB) and fine-needle aspiration (FNA) for pancreatic lesions.

METHODS AND MATERIAL: A total of 176 patients with 176 pancreatic lesions who visited our hospital between January 2016 and March 2021 were retrospectively analyzed. They were divided into three groups: FNA group A (<1.5 cm between the lesion and great vessels necessitating FNA), FNA group B, and CNB (the latter two with ≥1.5 cm between the lesion and great vessels necessitating FNA). The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and postoperative. The statistical analysis was done using Statistical Package for the Social Sciences version 17.0.

RESULTS: One hundred and seventy six patient’s specimens all met the requirements. There were no statistically significant differences in sensitivity, specificity, positive predictive value, negative predictive value, and accuracy between the CNB group and FNA group B, (P > 0.05). Thirteen samples submitted for genetic testing (5 in CNB group, 4 in each of the FNA groups A and B) all met the standards of next-generation sequencing gene detection. The main complications of these groups included abdominal pain, fever, and hyperamylasemia.

CONCLUSIONS: CT-guided percutaneous FNA and CNB have similar diagnostic efficacy for pancreatic biopsy. Furthermore, FNA has a wide range of puncture indications and is very safe. Like CNB, the obtained tissue through FNA can be genetically tested to guide clinical treatment.

PMID:37675715 | DOI:10.4103/jcrt.jcrt_1290_22

J Cancer Res Ther. 2023 Aug;19(4):898-903. doi: 10.4103/jcrt.jcrt_1098_21.

ABSTRACT

CONTEXT: Testis-specific protein Y-encoded-like 5 (TSPYL5) suppresses several cancers in vivo, including colorectal cancer (CRC); however, its mechanism and role in CRC cell tumorigenesis in vivo remain unknown.

AIMS: To elucidate the molecular mechanisms of colorectal cancer and find new therapeutic targets to improve CRC patient outcomes.

SETTINGS AND DESIGN: Male mice (4 weeks old, 16-22 g) were housed in sterile cages in a temperature-controlled room (20-25°C) with a 12 h light/dark cycle and ad libitum food and water.

METHODS AND MATERIALS: TSPYL5 overexpressing or non-overexpressing HCT116 cells were used to create a nude mouse tumor model. Tumor tissue was evaluated histologically after hematoxylin and eosin (H and E) staining. TUNEL staining assessed tumor cell apoptosis. Ki67 expression in excised tumor tissue was measured by immunohistochemistry. Western blotting examined double-stranded break (DBS)-associated protein expression in vivo.

STATISTICAL ANALYSIS USED: IBM SPSS Statistics for Windows, Version 21.0 was used for all analyses (IBM Corp., Armonk, NY, USA). At least three independent experiments yield a mean value ± standard deviation. Unpaired Student’s t-tests compared groups. One-way analysis of variance and Dunnett’s test were used to compare groups with a P value < 0.5.

RESULTS: TSPYL5 overexpression inhibited CRC cell tumorigenicity and damaged tumor cells in vivo. TSPYL5 overexpression also significantly increased Bax and p-H2AX (early double-stranded break indicators) and decreased Ki67, Bcl-2, and peroxisome proliferator-activated receptor expression.

CONCLUSIONS: Collectively, TSPYL5 overexpression inhibited the tumorigenicity of CRC cells in vivo by inducing DNA damage.

PMID:37675714 | DOI:10.4103/jcrt.jcrt_1098_21