Nevin Manimala

Zhonghua Yi Xue Za Zhi. 2023 Aug 8;103(29):2218-2224. doi: 10.3760/cma.j.cn112137-20230218-00231.

ABSTRACT

Objective: To analyze the influencing factors of futile recanalization after endovascular therapy (EVT) in acute ischemic stroke patients with large vessel occlusions (AIS-LVO). Methods: AIS-LVO patients who underwent EVT with successful recanalization between January 2019 and December 2021 in Neurovascular Center of Changhai Hospital of Naval Medical University were retrospectively selected. Modified Rankin scale (mRS) score 3 months after EVT was used as the prognostic evaluation index, and patients with mRS scores≤2 were classified as the meaningful recanalization group and mRS scores 3-6 as the futile recanalization group. The risk factors, National Institutes of Health stroke scale (NIHSS) score, Glasgow coma scale (GCS) score, Alberta Stroke Program Early CT (ASPECT) score, core infarct volume, etc. in both groups were analyzed, and the influencing factors of futile recanalization after EVT were analyzed by multivariate logistic regression. Continuous variables that do not conform to the normal distribution are represented by [M(Q₁,Q₃)]. Results: A total of 368 patients meeting the inclusion criteria were collected, including 228 males and 140 females, and aged 68 (61, 77) years. There are 196 patients and 172 patients in the meaningful recanalization and futile recanalization groups, respectively, with the rate of futile recanalization 3 months after EVT of 46.74% (172/368). Comparing the general information and risk factors between the two groups found that the age of patients in the futile recanalization group [71 (65, 79) years] was higher than that in the meaningful recanalization group [65 (59, 72) years]. The baseline NIHSS score [18 (14, 22)] and the rate of not achieving modified Thrombolysis in Cerebral Ischemia grade 3 (mTICI 3) reperfusion (36.1%) were higher in the futile recanalization group than those in the meaningful recanalization group [12 (7, 17) and 19.9%]. The baseline GCS score [11 (9, 13)] was lower in the futile recanalization group than that in the meaningful recanalization group [14 (11, 15)]. The core infarct volume in the futile recanalization group [28 (7, 65) ml] was larger than that in the meaningful recanalization group [6 (0, 17) ml]. The ASPECT score [7 (5, 9)] was lower in the futile recanalization group than that in the meaningful recanalization group [9 (7, 10)]. In addition, the proportion of hypertension, atrial fibrillation, general anesthesia, and symptomatic intracranial hemorrhage was higher in the futile recanalization group (all P<0.05). The time from symptom onset to puncture and from symptom onset to reperfusion was longer in the futile recanalization group (both P<0.05). There were statistically significant differences in trial of Org 10172 in acute stroke treatment (TOAST) classification and the site of occluded blood vessels between the two groups (both P<0.05). Multivariate logistic regression indicated that age ≥80 years(OR=1.935,95%CI: 1.168-3.205), baseline NIHSS score (OR=1.999,95%CI: 1.202-3.325), GCS score (OR=2.299,95%CI: 1.386-3.814), previous stroke history (OR=1.977,95%CI: 1.085-3.604), general anesthesia (OR=1.981,95%CI: 1.143-3.435), not achieving grade 3 recanalization (OR=2.846, 95%CI: 1.575-5.143), ASPECT score<6 (OR=2.616, 95%CI: 1.168-5.857), and core infarct volume>70 ml (OR=2.712, 95%CI: 1.130-6.505) were risk factors for futile recanalization. Conclusion: Age≥80 years, previous stroke history, baseline NIHSS score≥20, GCS score≤8, general anesthesia, ASPECT score<6, core infarct volume>70 ml, and failure to achieve Grade 3 recanalization are independent influencing factors for futile recanalization after endovascular therapy in AIS-LVO patients.

PMID:37544757 | DOI:10.3760/cma.j.cn112137-20230218-00231

Arch Psychiatr Nurs. 2023 Aug;45:89-100. doi: 10.1016/j.apnu.2023.04.026. Epub 2023 May 9.

ABSTRACT

BACKGROUND: Individuals diagnosed with bipolar disorder (BD) encounter difficulties in adherence to treatment and functionality. Although it is known that psychosocial interventions such as motivational interviewing (MI) and psychoeducation are important in regard to improving adherence to treatment and functionality, the content and nature of these interventions remain uncertain.

OBJECTIVE: This study was conducted to determine the effects of psychoeducation and MI on treatment adherence and functionality in individuals diagnosed with BD.

METHOD: In this study, a quasi-experimental pretest-posttest design with three groups was adopted. The study was completed with 119 participants in the MI (n = 32), psychoeducation (n = 31), and control (n = 56) groups.

RESULTS: There was a statistically significant improvement in the psychoeducation and MI groups in terms of treatment adherence compared to the control group (F = 32.672, p = 0.001, Partial η² = 0.364). Similarly, the psychoeducation and MI groups had significantly higher functionality levels compared to the control group, and significant differences were observed between the groups regarding the degree of improvement in functionality dimensions including the feeling of stigmatization (F = 8.433, p = 0.001, Partial η² = 0.129) and participation in social activities (F = 7.038, p = 0.001, Partial η² = 0.110).

CONCLUSION: It can be stated that psychoeducation and MI have positive effects in terms of improvement in treatment adherence and functionality in individuals diagnosed with BD.

PMID:37544708 | DOI:10.1016/j.apnu.2023.04.026

Arch Psychiatr Nurs. 2023 Aug;45:72-79. doi: 10.1016/j.apnu.2023.04.018. Epub 2023 May 9.

ABSTRACT

BACKGROUND: Using therapeutic techniques and conducting motivational interviews in communication with patients with schizophrenia increases individuals’ functional remission, insight, and motivation levels.

AIM: This single-blind, randomized controlled study examines the effect of Interpersonal Relations Theory-Based motivational interviews on functional remission and insight levels in patients with schizophrenia.

METHODS: The participants of this study were 40 patients with schizophrenia randomly assigned to either the experimental or control groups (20 in each group). The researchers carried out a 6-session Interpersonal Relations Theory-based motivational interview with the participants in the experimental group. Study data were collected using a demographic questionnaire, the Functional Remission of General Schizophrenia Scale (FROGS), and the Scale for Assessing the Three Components of Insight (SAI).

RESULTS: Social Functioning, Health and Treatment, Daily Living Skills, and SAI scores of the individuals in the intervention group were statistically higher than those in the control group (p < 0.05) in the post-intervention and follow-up measures. There was a positive and significant correlation between the post-intervention Social Functioning, Health and Treatment, Daily Life Skills, and total FROGS scores and the SAI score of the individuals in the intervention group (p < 0.05).

CONCLUSIONS: It was concluded that motivational interviews based on Interpersonal Relations Theory were effective in increasing the insights and functionality of patients with schizophrenia. Psychiatric nurses’ practice of motivational interviews based on the therapeutic relationship is considered to increase the quality of care and satisfaction of patients with schizophrenia. It is recommended that this practice be used extensively in clinical practice.

PMID:37544705 | DOI:10.1016/j.apnu.2023.04.018

Arch Psychiatr Nurs. 2023 Aug;45:152-157. doi: 10.1016/j.apnu.2023.06.012. Epub 2023 Jun 21.

ABSTRACT

OBJECTIVE: The study was conducted to investigate the effect of technology addiction training given to nursing students on their Internet and technology addiction perspectives and addiction levels.

METHOD: The data of the experimental research with a control group and a pretest-posttest design were collected online using the Personal Information Form and the Technology Addiction Scale. Sample size was 82. Technology addiction training was given for 10 weeks. Post-test data were collected after the training. The Mann Whitney-U test, t-test, Tukey HSD test, Kruskal Wallis test, and Bonferroni-Dunn test were used for statistical analysis. The Fisher’s Exact Test and the Chi-Square test were used to analyze the categorical variables.

RESULTS: The level of technology addiction of the students in the experimental group was 52.69 ± 17.218 in the pre-test and 51.31 ± 14.931 in the post-test. In the control group, the level of technology addiction was found to be 54.03 ± 18.955 in the pre-test and 53.39 ± 20.159 in the post-test. Thus, it can be stated that the students in both groups were moderately addicted to technology and no significant difference was observed between the pre-test and post-test mean scores of the groups after the training.

CONCLUSION: The study revealed that the students were moderately addicted to technology and used technological devices at a high rate. In addition, the ineffectiveness of the training, and being aware of the harms of technology, but disregarding the importance of these harms were the interesting findings that showed the severity of the problem.

CLINICAL TRIALS ID: NCT05277545.

PMID:37544691 | DOI:10.1016/j.apnu.2023.06.012

Arch Psychiatr Nurs. 2023 Aug;45:101-112. doi: 10.1016/j.apnu.2023.04.027. Epub 2023 May 9.

ABSTRACT

INTRODUCTION: Research has shown that application of emotional freedom technique and music ensures psychological growth, increases well-being, and decreases cortisol level.

PURPOSE: In the study, it was aimed to determine the effect of EFT and music applied to pregnant women who had experienced prenatal loss on their psychological growth, well-being, and cortisol level.

METHODS: The study was conducted as a randomized controlled trial in a city hospital in eastern Türkiye with 159 pregnant women, 53 of whom were in the EFT, 53 in the music group, and 53 in the control group. The study data were collected through Subjective Units of Disturbance Scale (SUDS), Subjective Units of Experience (SUE) Scale, Post Traumatic Growth Inventory (PTGI), and WHO-5 Well-Being Index, and saliva samples were taken for cortisol evaluation. EFT was applied to the women two times every other week; the women in the music group listened to music two times every other week. Throughout the week following the first intervention, the women continued the interventions at home.

RESULTS: It was determined that EFT and music significantly decreased the participants’ subjective anxiety and salivary cortisol median scores, the lowest anxiety was in the EFT group, and PTGI and WHO-5 Well-Being Index mean scores increased (p < 0.005). Further analyses showed that EFT was more effective in terms of increasing well-being than music (p < 0.001; a > b > c). It was determined that the anxiety levels and salivary cortisol median values of the control group were statistically significantly higher compared to the EFT and music groups (p < 0.001).

CONCLUSION: It was found that EFT and music applied to the women who had experienced prenatal loss decreased anxiety, ensured psychological growth, improved well-being, and decreased salivary cortisol level.

PMID:37544684 | DOI:10.1016/j.apnu.2023.04.027

Int J Hyperthermia. 2023;40(1):2240548. doi: 10.1080/02656736.2023.2240548.

ABSTRACT

OBJECTIVE: This nonrandomized prospective clinical trial aimed to assess the efficacy, safety and follow-up outcomes of ultrasound-guided high-intensity focused ultrasound (USgHIFU) surgery in patients with breast fibroadenoma.

METHODS: With the approval of the institutional ethics committee and written informed consent, a total of 113 patients diagnosed with breast fibroadenoma by core-needle biopsy in our hospital were recruited. USgHIFU surgery was performed under local anesthesia. Contrast-enhanced ultrasound (CEUS) or contrast-enhanced MRI (CEMRI) was performed to evaluate the nonperfused volume (NPV). The patients were followed up with physical examination and ultrasound imaging.

RESULTS: The clinical outcome of 85 patients with 147 fibroadenomas with a follow-up time of more than 3 months was analyzed in this study. Fifty-two patients had one lesion, twenty-one patients had two lesions and twelve patients had more than two lesions. During USgHIFU, the median localization time for all fibroadenomas was 3 (interquartile range: 1, 5) min, and the median treatment time was 9 (interquartile range: 5, 15) min. Under local anesthesia, all the patients tolerated the treatment well. No serious epidermal burns were observed in any of the patients. Based on CEUS or CEMRI imaging evaluation, the median NPV ratio was 100% (interquartile range: 79.2%, 116.8%). The VRR were 26.77 ± 50.05%, 50.22 ± 42.01% and 72.74 ± 35.39% at 3-6 months, 6-12 months and >12 months, respectively, which showed significant statistical difference (p < .001).

CONCLUSION: Ultrasound-guided HIFU surgery is an effective and safe noninvasive alternative technique for the treatment of breast fibroadenoma.

PMID:37544652 | DOI:10.1080/02656736.2023.2240548

Aust Vet J. 2023 Aug 6. doi: 10.1111/avj.13268. Online ahead of print.

ABSTRACT

OBJECTIVE: To provide complete anatomical and ultrasonographic description of tendons and ligaments at the palmar (plantar) aspect of the cannon and phalangeal regions of the one-humped camel.

DESIGN: Forty-two (21 fore and 21 hind) clinically normal camel cadavers’ limbs disarticulated at the carpal and tarsal joints and three clinically normal mature camels were included in the study. Six cadaver limbs (three fore and three hind) were dissected, and another six limbs specimens (three fore and three hind) were frozen at -20° for 1 week then sectioned transversely with an electric band saw at different distances distal to the carpometacarpal and tarsometatarsal joints. The ultrasonographic study was carried out on the live camels and 30 cadaveric limbs. The shape, echogenicity and measurements (thickness, width and cross-sectional area) of superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), suspensory ligament (SL), and sesamoidean ligaments were recorded and the differences in values between live animals and cadaveric specimens were statistically analysed.

RESULTS: The shape and echogenicity of SDFT, DDFT, and SL, varied between proximal, middle, and distal thirds of the cannon bone and the phalangeal region. There was no significant difference between live animal and cadaveric specimens.

CONCLUSION: This study provided complete description of tendons and ligaments at the palmar (plantar) aspect of the cannon and phalangeal region of the one humped camel. The data obtained serves as a reference guide for practicing veterinarians and for future studies on injury to ligaments and tendons of camel’s distal extremity.

PMID:37544650 | DOI:10.1111/avj.13268

Curr Probl Cardiol. 2023 Aug 4:102006. doi: 10.1016/j.cpcardiol.2023.102006. Online ahead of print.

ABSTRACT

In recent years, there has been a notable and concerning rise in the prevalence of mental disorders, indicating a growing societal challenge that warrants attention and support for affected individuals. Psychiatric problems range on a wide spectrum from as little as work or school related stress to as big as severe depression related to the loss of a loved one, a sense of loneliness, etc. This current generation yields the highest amounts of mental disorder patients due to the newfound pressures, difficulties, and ways of life. According to the Center for Disease Control and Prevention (CDC), more than 1 in 5 U.S. adults live with a mental illness and about 1 in 25 U.S. adults live or lived with a serious mental illness such as schizophrenia, bipolar disorder, or major depression. A similar statistic shows us that about 695,000 people in the U.S. in 2021 died due to some form of heart related disease. That’s 1 in every 5 deaths. More recently, it has been noticed that these psychiatric disorders and heart diseases could be correlated. In this manuscript, we review the current literature on the effect and correlation of psychiatric disorders on the cardiovascular system. We present a review on primarily the “5 major psychiatric disorders,” according to the NIH: depression, autism, ADHD, bipolar disorder, and schizophrenia (Table 1). We will also present a review on stress-induced cardiac diseases, especially more recently with the rise of the COVID-19 Pandemic.

PMID:37544626 | DOI:10.1016/j.cpcardiol.2023.102006

Cir Esp (Engl Ed). 2023 Aug 4:S2173-5077(23)00140-0. doi: 10.1016/j.cireng.2023.04.020. Online ahead of print.

ABSTRACT

INTRODUCTION: Robot-assisted thoracic surgery (RATS) is a rapidly expanding technique. In our study, we aimed to analyze the results of the process to adopt robotic surgery in our Department of Thoracic Surgery.

METHODS: This is an intention-to-treat analysis of a series of consecutive patients operated on using the RATS approach in our hospital from January 2021 to March 2022. Data were registered for patient characteristics, type of surgery, operative times, conversion rate, chest tube duration, length of hospital stay and complications. The IBM SPSS® statistical software was used for the statistical analysis. A cumulative sum analysis of the operating time was performed to define the learning curve.

RESULTS: During the study period, 51 patients underwent robotic surgery, including pulmonary and non-pulmonary interventions. In addition, 15 patients (29.4%) underwent non-pulmonary interventions: one pleural (2%), 2 diaphragmatic (3.9%), and 12 mediastinal (23.5%). Among the mediastinal surgeries, one conversion was necessary (8.3%) for a complex vascular malformation, and 11 were completed by RATS, including 7 (58.3%) thymomas, 3 (25%) pleuro-pericardial cysts, and one (8.3%) neurogenic tumor. Mean operative time was 141 minutes (104-178), mean chest tube duration was 0.9 days (0-2), and mean length of stay was 1.45 days (1-2). Thirty-six patients underwent lung surgery (70.6%). The complete RATS resections (34; 94.4%) included: 3 wedge resections (11.1%), 2 segmentectomies (3.7%), 28 lobectomies (81.5%), and one sleeve lobectomy (3.7%). Mean surgery time was 194.56 minutes (141-247), chest tube duration was 3.92 days (1-8), and length of stay was 4.6 days (1-8). Complications occurred in 4 patients (11.1%). No 90-day mortalities were registered.

CONCLUSIONS: The implementation of RATS was achieved with good clinical results and operative times for all indications. A rapid learning curve was accomplished in short time. Previous VATS experience, patient selection, team training and program continuity are fundamental to successfully develop a RATS program.

PMID:37544607 | DOI:10.1016/j.cireng.2023.04.020

World Neurosurg. 2023 Aug 4:S1878-8750(23)01101-4. doi: 10.1016/j.wneu.2023.07.148. Online ahead of print.

ABSTRACT

OBJECTIVES: Percutaneous cement discoplasty (PCD) was introduced to treat symptomatic vertical instability of the lumbar spine in a minimally invasive way. The aim of the present study was to analyse the complication pattern after PCD and to identify factors that predict the chance of cement leakage, reoperation and length of hospital stay (LOS).

METHODS: 344 patients were treated with PCD within the study period. Clinical features and complications were analysed by applying descriptive statistics, while perioperative factors predictive of cement leakage, reoperation and LOS were identified by regression models.

RESULTS: Cement leakage rate was 30.4 % in the total cohort, however only fifth of them were symptomatic. Cement leakage itself did not have a significant influence on clinical outcome. Other complications and non-surgical adverse events were registered only in 2.0% of cases. Age, BMI, low viscosity cement, lower level of surgeon’s experience and the number of operated levels were identified as risk factors of cement leakage (p<0.01, c-index=0.807). Type of procedure, Charlson comorbidity score, reoperation and non-surgical adverse events significantly increased the LOS (p<0.01). Cement leakage, early surgical practice and high BMI were risk factors for reoperation (p<0.01, c-index=0.72).

CONCLUSION: In summary, PCD is a relatively safe and effective procedure for treating spinal instability due to advanced stage disc degeneration characterized by vacuum phenomenon. Cement leakage is not uncommon but only a radiologic complication without clinical consequences in most cases. On the other hand, it can increase the LOS and it is a significant risk factor for reoperation.

PMID:37544606 | DOI:10.1016/j.wneu.2023.07.148