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Application of self-anchored lateral lumbar interbody fusion in lumbar degenerative diseases

BMC Musculoskelet Disord. 2023 Oct 23;24(1):836. doi: 10.1186/s12891-023-06974-x.

ABSTRACT

STUDY DESIGN: This is a retrospective study.

OBJECTIVE: The aim of the study was to evaluate the efficacy of self-anchored lateral lumbar interbody fusion (SA-LLIF) in lumbar degenerative diseases.

METHODS: Forty-eight patients with lumbar degenerative disease between January 2019 and June 2020 were enrolled in this study. All patients complained of low back and leg pain, which were aggravated during standing activities and alleviated or disappeared during lying. After general anesthesia, the patient was placed in the right decubitus position. The anterior edge of the psoas major muscle was exposed through an oblique incision of approximately 6 cm, using an extraperitoneal approach. The psoas major muscle was then properly retracted dorsally to expose the disc. After discectomy, a suitable cage filled with autogenous bone graft from the ilium was implanted. Two anchoring plates were inserted separately into the caudal and cranial vertebral bodies to lock the cage. Clinical efficacy was evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI). Lumbar lordosis, intervertebral disc height, spondylolisthesis rate, cage subsidence and fusion rate were also recorded.

RESULTS: A total of 48 patients were enrolled in this study, including 20 males and 28 females, aged 61.4 ± 7.3 (range 49-78) years old. Surgery was successfully performed in all patients. Lumbar stenosis and instability were observed in 22 cases, disc degenerative disease in eight cases, degenerative spondylolisthesis in nine cases, degenerative scoliosis in six cases, and postoperative revision in three cases. In addition, five patients were diagnosed with osteoporosis. The index levels included L2-3 in three patients, L3-4 in 13 patients, L4-5 in 23 patients, L2-4 in three patients, and L3-5 in six patients. The operation time was 81.1 ± 6.4 (range 65-102) min. Intraoperative blood loss was 39.9 ± 8.5 (range 15-72) mL. No severe complications occurred, such as nerve or blood vessel injuries. The patients were followed up for 11.7 ± 2.3 (range 4-18) months. At the last follow-up, the VAS decreased from 6.2 ± 2.3 to 1.7 ± 1.1, and the ODI decreased from 48.4% ± 11.2% to 10.9% ± 5.5%. Radiography showed satisfactory postoperative spine alignment. No cage displacement was found, but cage subsidence 2-3 mm was found in five patients without obvious symptoms, except transient low back pain in an obese patient. The lumbar lordosis recovered from 36.8° ± 7.9° to 47.7° ± 6.8°, and intervertebral disc height recovered from 8.2 ± 2.0 mm to 11.4 ± 2.5 mm. The spondylolisthesis rate decreased from 19.9% ± 4.9% to 9.4% ± 3.2%. The difference between preoperative and last follow-up was statistically significant (P<0.05).

CONCLUSION: SA-LLIF can provide immediate stability and good results for lumbar degenerative diseases with a standalone anchored cage without posterior internal fixation.

PMID:37872610 | DOI:10.1186/s12891-023-06974-x

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Systemic sclerosis and risk of bronchiectasis: a nationwide longitudinal cohort study

Arthritis Res Ther. 2023 Oct 23;25(1):209. doi: 10.1186/s13075-023-03189-2.

ABSTRACT

BACKGROUND: The association between systemic sclerosis and the development of bronchiectasis is unclear. This study aimed to compare the risk of bronchiectasis between individuals with systemic sclerosis and those without using a nationwide longitudinal dataset.

METHODS: Using the Korean National Health Insurance Service dataset between 2010 and 2017, we identified 4845 individuals aged ≥ 20 years with systemic sclerosis and 24,225 without systemic sclerosis who were matched 1:5 by age and sex. They were followed up until the date of a bronchiectasis diagnosis, death, or December 31, 2019, whichever came first.

RESULTS: During a median follow-up period of 6.0 (interquartile range, 3.2-8.7) years, 5.3% of the systemic sclerosis cohort and 1.9% of the matched cohort developed bronchiectasis, with incidence rates of 9.99 and 3.23 per 1000 person-years, respectively. Even after adjusting for potential confounders, the risk of incident bronchiectasis was significantly higher in the systemic sclerosis cohort than in the matched cohort (adjusted hazard ratio 2.63, 95% confidence interval 2.22-3.12). A subgroup analysis of individuals with systemic sclerosis revealed that the risk of incident bronchiectasis was notably higher in younger individuals aged 20-39 years (P for interaction = 0.048) and in those without other coexisting connective tissue diseases (P for interaction = 0.006) than in their counterparts.

CONCLUSIONS: The risk of incident bronchiectasis is higher in individuals with systemic sclerosis than those without. Bronchiectasis should be considered one of the pulmonary manifestations related to systemic sclerosis.

PMID:37872606 | DOI:10.1186/s13075-023-03189-2

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Use of wild edible and nutraceutical plants in Raya-Azebo District of Tigray Region, northern Ethiopia

Trop Med Health. 2023 Oct 24;51(1):58. doi: 10.1186/s41182-023-00550-8.

ABSTRACT

BACKGROUND: Although there is a wide use of wild edible plants (WEPs) in Ethiopia, very little work has so far been done, particularly, in the Tigray Region, northern Ethiopia, to properly document the associated knowledge. The purpose of this study was, therefore, to document knowledge and analyze data related to the use of wild edible and nutraceutical plants in Raya-Azebo District of Tigray Region. The district was prioritized for the study to avoid the further loss of local knowledge and discontinuation of the associated practices because of the depletion of wild edible plants in the area mainly due to agricultural expansion and largely by private investors.

METHODS: A cross-sectional ethnobotanical study was carried out in the study District to collect data through individual interviews held with purposively selected informants, observation, market surveys, and ranking exercises. Descriptive and inferential statistical methods were employed to analyze and summarize the data using Statistical Package for Social Sciences (SPSS) version 16.

RESULTS: The study documented 59 WEPs, the majority of which (57.63%) were sought for their fruits. Most of the WEPs (49 species) were consumed in the autumn, locally called qewei, which includes the months of September, October, and November. Ziziphus spina-christi L. Desf., Balanites aegyptiaca (L.) Del. and Opuntia ficus-indica (L.) Miller were the most preferred WEPs. Both interviews and local market surveys revealed the marketability of Opuntia ficus-indica, Ziziphus spina-christi, Ficus vasta Forssk., Ficus sur Forssk., and Balanites aegyptiaca. Of the total WEPs, 21 were reported to have medicinal (nutraceutical) values, of which Balanites aegyptiaca and Acacia etbaica scored the highest rank order priority (ROP) values for their uses to treat anthrax and skin infections, respectively.

CONCLUSIONS: The current investigation demonstrated the wide use of WEPs in the district. In future nutritional composition analysis studies, priority should be given to the most popular WEPs, and nutraceutical plants with the highest ROP values.

PMID:37872596 | DOI:10.1186/s41182-023-00550-8

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Acteoside protects podocyte against apoptosis through regulating AKT/GSK-3β signaling pathway in db/db mice

BMC Endocr Disord. 2023 Oct 23;23(1):230. doi: 10.1186/s12902-023-01483-3.

ABSTRACT

BACKGROUND: Podocyte apoptosis is one of the important pathological mechanisms of diabetic kidney disease (DKD). Acteoside (Act), a major active component of Rehmannia glutinosa leaves total glycoside, has a strong renoprotective action. Our study aims to demonstrate Act’s renoprotective actions in db/db mice.

METHODS: We adopted C57BLKS/J db/db mice as DKD animal models. After 8 weeks of Act administration, the 24-hour urine albumin, renal function index, and blood lipid levels were quantified using matching kits. Renal pathology was evaluated by HE and PAS staining. The podocyte damage and apoptosis-related signaling pathway were observed by using immunohistochemistry, western blot, and TUNEL staining.

RESULTS: The albuminuria of db/db mice was reduced from 391 ug/24 h to 152 ug/24 h, and renal pathology changes were alleviated after Act administration. The western blot and immunohistochemistry showed that Act treatment upregulated the synaptopodin and podocin expression compared with db/db mice, while the TUNEL staining indicated podocyte apoptosis was inhibited. The B-cell lymphoma-2 (Bcl-2) level was upregulated in the Act group, but cleaved caspase-3 and Bcl-2 associated X protein (Bax) expression declined, while the protein kinase B/glycogen synthase kinase-3β (AKT/GSK-3β) signaling pathway was repressed.

CONCLUSIONS: By inhibiting the AKT/GSK-3β signaling pathway, Act protected podocytes from apoptosis, decreasing the urine albumin of db/db mice and delaying the course of DKD.

PMID:37872577 | DOI:10.1186/s12902-023-01483-3

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Filaggrin gene variants among Saudi patients with ichthyosis vulgaris

BMC Med Genomics. 2023 Oct 23;16(1):256. doi: 10.1186/s12920-023-01700-x.

ABSTRACT

Ichthyoses are a heterogeneous group of cornification disorders. The most common form of ichthyoses is ichthyosis vulgaris (IV) ([OMIM] #146,700), which can be inherited as autosomal semi-dominant mutation in the filaggrin gene (FLG). We present the findings of a study involving 35 Saudi patients with a clinical diagnosis of ichthyosis vulgaris. For identifying the pathogenic mutation of their disease, we used Sanger sequencing analysis of the extracted DNA samples. We also identified the underlying 22 FLG variants, which have been seen before. However, the detected mutations do not involve the common p.R501* c. 2282del4 mutations reported in European populations. Indeed, we did not identify any statistical influence of the homozygous or heterozygous genotypes on the phenotype severity of the disease.

PMID:37872553 | DOI:10.1186/s12920-023-01700-x

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A 10-year update to the principles for clinical trial data sharing by pharmaceutical companies: perspectives based on a decade of literature and policies

BMC Med. 2023 Oct 23;21(1):400. doi: 10.1186/s12916-023-03113-0.

ABSTRACT

Data sharing is essential for promoting scientific discoveries and informed decision-making in clinical practice. In 2013, PhRMA/EFPIA recognised the importance of data sharing and supported initiatives to enhance clinical trial data transparency and promote scientific advancements. However, despite these commitments, recent investigations indicate significant scope for improvements in data sharing by the pharmaceutical industry. Drawing on a decade of literature and policy developments, this article presents perspectives from a multidisciplinary team of researchers, clinicians, and consumers. The focus is on policy and process updates to the PhRMA/EFPIA 2013 data sharing commitments, aiming to enhance the sharing and accessibility of participant-level data, clinical study reports, protocols, statistical analysis plans, lay summaries, and result publications from pharmaceutical industry-sponsored trials. The proposed updates provide clear recommendations regarding which data should be shared, when it should be shared, and under what conditions. The suggested improvements aim to develop a data sharing ecosystem that supports science and patient-centred care. Good data sharing principles require resources, time, and commitment. Notwithstanding these challenges, enhancing data sharing is necessary for efficient resource utilization, increased scientific collaboration, and better decision-making for patients and healthcare professionals.

PMID:37872545 | DOI:10.1186/s12916-023-03113-0

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Surgery for stage IIB-IIIB small cell lung cancer

World J Surg Oncol. 2023 Oct 23;21(1):333. doi: 10.1186/s12957-023-03196-2.

ABSTRACT

PURPOSE: The NCCN guidelines do not recommend surgery for T3-4N0M0/T1-4N1-2M0 small cell lung cancer (SCLC) due to a lack of evidence.

METHODS: Data of patients with T3-4N0M0/T1-4N1-2M0 SCLC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database to determine the impact of surgery on this population. The Kaplan-Meier method, univariable and multivariable Cox proportional hazard regression, and propensity score matching (PSM) were used to compare the overall survival (OS) between the surgery and non-surgery groups. In addition, we explored whether sublobectomy, lobectomy, and pneumonectomy could provide survival benefits.

RESULTS: In total, 8572 patients with SCLC treated without surgery and 342 patients treated with surgery were included in this study. The PSM-adjusted hazard ratio (HR, 95% CI) for surgery vs. no surgery, sublobectomy vs. no surgery, lobectomy vs. no surgery, pneumonectomy vs. no surgery, and lobectomy plus adjuvant chemoradiotherapy vs. chemoradiotherapy were 0.71 (0.61-0.82) (P < 0.001), 0.91 (0.70-1.19) (P = 0.488), 0.60 (0.50-0.73) (P < 0.001), 0.57 (0.28-1.16) (P = 0.124), and 0.73 (0.56-0.96) (P = 0.023), respectively. The subgroup analysis demonstrated consistent results.

CONCLUSIONS: Lobectomy improved OS in patients with T3-4N0M0/T1-4N1-2M0 SCLC, while pneumonectomy also demonstrated a tendency to improve OS without statistical significance; however, sublobectomy showed no survival benefit.

PMID:37872542 | DOI:10.1186/s12957-023-03196-2

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Evaluation of compressive strength, surface microhardness, solubility and antimicrobial effect of glass ionomer dental cement reinforced with silver doped carbon nanotube fillers

BMC Oral Health. 2023 Oct 23;23(1):777. doi: 10.1186/s12903-023-03542-6.

ABSTRACT

BACKGROUND: Conventional glass ionomer cements (GICs) are currently the most widely used dental cements due to their chemical bonding into tooth structure, release of fluoride, and ease of manipulation and usage. One of their drawbacks is their low mechanical properties and high solubility. Carbon nanotubes (CNTs) could be utilized in dentistry due to their several potential applications. CNTs can be used as fillers to reinforce polymers or other materials. Additionally, silver (Ag) nanoparticles are highly effective at preventing dental biofilm and enhancing mechanical properties.

OBJECTIVES: The aim of the present in vitro study is to evaluate the compressive strength, surface microhardness, solubility, and antimicrobial effect of the conventional GIC reinforced with manual blending of 0.01 wt.% Ag doped CNT fillers.

METHODS: The control group was prepared by mixing dental GIC powder with their liquid. The innovatively reinforced dental GIC group was prepared by incorporating 0.01 wt.% Ag doped CNT fillers into the GIC powder prior to liquid mixing. Chemical characterization was performed by XRF. While, physical characterization was done by measuring film thickness and initial setting time. The compressive strength, surface microhardness, solubility, and antimicrobial effect against Streptococcus mutans bacteria using an agar diffusion test were measured. The data was statistically analyzed using independent sample t-tests to compare mean values of compressive strength, surface microhardness, solubility, and antimicrobial activity (p ≤ 0.05).

RESULTS: The results revealed that innovative reinforced GIC with 0.01 wt.% Ag doped CNT fillers showed higher mean compressive strength, surface microhardness, and antimicrobial effect values than the conventional GIC control group; there was no significant difference between different groups in relation to the solubility test (P ≤ 0.05).

CONCLUSION: The innovatively reinforced GIC with 0.01 wt.% Ag doped CNT fillers had the opportunity to be used as an alternative to conventional GIC dental cements.

PMID:37872523 | DOI:10.1186/s12903-023-03542-6

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Identifying factors that affect the use of health information technology in the treatment and management of hypertension

BMC Med Inform Decis Mak. 2023 Oct 23;23(1):235. doi: 10.1186/s12911-023-02284-3.

ABSTRACT

BACKGROUND: We conducted this study with the aim of identifying factors that affect the use of health information technology in the treatment and management of hypertension.

METHODS: This paper is a descriptive-analytic study conducted in 2022. To obtain relevant articles, databases including Scopus, Web of Science, IEEE, and PubMed were searched and the time period was between 2013 and 2022. Based on the review of similar articles, a five-point Likert scale checklist was developed in the second phase. The statistical population of the present study was specialist physicians (N = 40) and patients (N = 384). In order to analyze the data, SPSS Statistics 24 was used. To analyze the data obtained from the checklist, we used summary statistics (mean and standard deviation).

RESULTS: As a result of the review literature process, 50 papers were screened, that based we can distinguish motivational and inhibitory factors affecting the use of health information technology in hypertension management. Indeed, Motivational factors and inhibitory factors can be classified into five groups: organizational, economic, technical, personal, and legal/moral factors. Based on the results of the checklist, the factors that were identified as most influential on motivation and inhibitory patients and specialist physicians’ to use of health information technology to manage and treat hypertension.

CONCLUSION: Utilizing technologies for hypertension, its management can be improved by identifying motivating and inhibiting factors. Our approach can improve the acceptability of these technologies, save costs, reduce long-term complications of hypertension, and improve patient quality of life.

PMID:37872522 | DOI:10.1186/s12911-023-02284-3

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Functional outcome in patients with hip fracture from 2008 to 2018, and the significance of hand-grip strength – a cross-sectional comparative study

BMC Geriatr. 2023 Oct 23;23(1):686. doi: 10.1186/s12877-023-04398-9.

ABSTRACT

BACKGROUND: Incidence of hip fracture is estimated to rise, increasing demands on healthcare. Our objective was to compare patients with hip fracture, a decade apart, regarding surgical characteristics and functional outcome in relation to morbidity. A secondary aim was to analyse postoperative hand-grip strength (HGS) in relation to walking ability 4 months postoperatively.

METHODS: This is a cross-sectional comparative study of patients with hip fracture, included in 2008 (n = 78) and 2018 (n = 76) at Örebro University Hospital. Patient-data (age, gender, morbidity, fall-circumstances, fracture, surgical characteristics, and length of stay) were collected from medical records. HGS was measured postoperatively. Data on functional outcome in terms of housing, walking ability and need of walking aids at 4 months postoperatively was collected from the Swedish Hip Fracture Register RIKSHÖFT. Statistical analyses adapted were hypothesis tests and regression analysis.

RESULTS: Patients in 2018 presented a significantly higher morbidity than patients in 2008 and there were significant differences in adapted surgical methods. Functional outcome at 4-months postoperatively was analysed by logistic regression where Cohort 2018 was associated with higher odds of independent walking ability (OR 5.7; 95%CI 1.9-17.2) and not needing any walking aids (OR 5.1; 95%CI 1.9-17.2). Postoperative HGS was higher among patients in 2018 and a multiple regression analysis revealed a significant association between HGS and walking ability at 4 months postoperatively.

CONCLUSIONS: This study supports the since previously reported development in hip fracture surgery in Sweden while also presenting that functional outcome seems to have improved despite a concomitant increase in morbidity. Results suggest an improvement in postoperative HGS, predicting walking ability at 4 months postoperatively.

PMID:37872510 | DOI:10.1186/s12877-023-04398-9