Nevin Manimala

P R Health Sci J. 2021 Sep;40(3):127-135.

ABSTRACT

OBJECTIVE: To evaluate, in pregnant women at risk for preeclampsia, the effect of an education and counseling program on healthy lifestyle behaviors, self-efficacy, and maternal/neonatal outcomes.

METHODS: This study had a randomized controlled trial design and was conducted with 132 pregnant women at risk of preeclampsia and attending an antenatal clinic for routine care. The intervention group received education and counseling focused on preventing preeclampsia and were given a preeclampsia booklet; the control group received standard prenatal care. The members of the 2 groups were seen 4 times during their pregnancies, and once after giving birth. Data were gathered with the Health Promoting Lifestyle Profile-II, the Self-Efficacy Scale (SES), pregnant woman and fetal follow-up forms, and a postpartum data collection form. Permission from the ethics committee was obtained for the study.

RESULTS: Education and counseling about preeclampsia had a statistically significant effect on healthy lifestyle behaviors (P < .008). However, we found no statistically significant differences in the total SES scores (P > .0125), systolic and diastolic blood pressure averages, edema status, or feeling the baby move (P > .05). We found differences in terms of physical activity in the first and third follow-ups, and in terms of breathing exercises in the first, second, and third follow-ups (P < .05). Preeclampsia developed in 4 of the pregnant women (7.6%) in the control group but not at all in the intervention group.

CONCLUSION: A preeclampsia education and counseling program could help to develop healthy lifestyle behaviors in pregnant women at risk of preeclampsia.

PMID:34792926

P R Health Sci J. 2021 Sep;40(3):115-119.

ABSTRACT

OBJECTIVE: To estimate the prevalence of short root anomaly (SRA) in a group of Puerto Ricans at the Advanced Education Program in Orthodontics of the University of Puerto Rico.

METHODS: A cross-sectional study was conducted with digital panoramic x-rays of 203 patients (112 females and 91 males; mean age: 17 years) in Puerto Rico. Utilizing the modified Lind’s method, 406 maxillary right and left central incisors (1) were measured and evaluated for SRA. Root and crown length and R/C ratio were compared by sex and side. Linear regression was used to evaluate the associations between the R/C ratio and age, sex, and side (right/left). All the statistical analyses were evaluated using significance level of .05 (2).

RESULTS: The prevalence of SRA was 0.49%. The average root and crown lengths for the maxillary right and left central incisors were 19.47 and 10.28 mm, respectively. Sex was associated with root and crown length, not with the R/C ratio. No differences were observed in the R/C ratio by the side. There were no significant associations between age, sex, and side and R/C ratio in the multivariate analysis.

CONCLUSION: The prevalence of SRA in our population is lower than any reported in the literature. The R/C ratio in our Hispanic population was the highest compared with those of other ethnicities. Neither the sex nor the side of the incisor was associated with the R/C ratio. These findings are contrary to those of prior reports stating that males have higher R/C ratios than females.

PMID:34792924

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Aug;29(Special Issue):1388-1394. doi: 10.32687/0869-866X-2021-29-s2-1388-1394.

ABSTRACT

The article provides information that allows you to form an idea of the health status of children of different age groups living in Moscow. The sources of information were data on the population size, federal statistical observation form No. 12 «Information on the number of diseases registered in patients living in the service area of a medical organization» for the period from 2016 to 2020. The morbidity analysis was carried out by age groups 0-4, 5-9, 10-14, 0-14, 15-17 years per 100,000 of the corresponding population.

PMID:34792894 | DOI:10.32687/0869-866X-2021-29-s2-1388-1394

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Aug;29(Special Issue):1338-1342. doi: 10.32687/0869-866X-2021-29-s2-1338-1342.

ABSTRACT

INTRODUCTION: Thanks to advances in science and medicine, the threshold age of a patient who can undergo open surgery on the valves of the heart or coronary arteries is increasing every year. Elderly patients constitute a special group in this regard.

AIM: Determine how elderly cardiac patients assess their health status and highlight the factors influencing it.

MATERIALS AND METHODS: The results of a survey of 107 patients who are in the Department of cardiac rehabilitation of the A. N. Bakulev National Medical Research Center for Cardiovascular Surgery in 2020-2021 after surgical or endovascular treatment of cardiac pathology. The survey is carried out by a cardiologist using a questionnaire that allows you to characterize the patient’s health status on the basis of self-esteem. Statistical data processing was carried out in Microsoft Office Excel 2003 and Statistica v. 6.0 programs.

RESULTS: The majority of respondents (63.6%) assessed their state of health as satisfactory. No correlation was found between the state of health and the level of education. On average, the patients had 3.7 ± 1.8 chronic diseases. Obesity was observed in 29.4% of men and 68.8% of women. The body mass index did not correlate with the self-reported health status of the respondents, but it did correlate with the number of accumulated diseases (r = 0.42, t-statistic = 2.58).

CONCLUSIONS: Recovery of elderly patients after cardiac surgery is progressing rapidly. In women, the recovery process is slower due to the greater number of associated pathologies. Old age is not a direct contraindication for cardiac surgery. When self-assessing their health status, elderly patients do not associate it with risk factors.

PMID:34792887 | DOI:10.32687/0869-866X-2021-29-s2-1338-1342

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 Aug;29(Special Issue):1287-1291. doi: 10.32687/0869-866X-2021-29-s2-1287-1291.

ABSTRACT

INTRODUCTION: Liver cirrhosis is a major but preventable cause of health loss worldwide. The era of «big data» allows us to evaluate this nosology in a new format.

PURPOSE: Evaluation of the registered population of patients with cirrhosis of the liver of cirrhosis of various etiology in Moscow. Moscow.

MATERIALS AND METHODS: Based on the data of the Moscow Department of Healthcare for the drug provision for the period from 2017 to 2019. Тhe population of patients with an established diagnosis of liver (other etiology) was characterized according to ICD-10 code K.74 (K74.0-74.6) according to the International Statistical Classification of Diseases and Related Health Problems of the 10th revision.

RESULTS: Over a 4-year period, more than 2 thousand patients with established diagnosis of liver cirrhosis received preferential drug provision in Moscow. The largest part of the population of patients with liver cirrhosis receiving preferential drug provision in Moscow is represented by the patients of age groups 40-59 years old and 60-79 years old, the groups 30-39 years old and 80-99 years old were comparable annually. There was a decrease in the number of patients with liver cirrhosis in the age groups of 30-39 and 18-19 years compared with the base year (2017) by 37% and 57%, respectively. At the same time, in pediatric patients (from the neonatal period to 17 years), there was an intensive increase in patients from 52 to 550% compared to the baseline year (2017).

PMID:34792879 | DOI:10.32687/0869-866X-2021-29-s2-1287-1291

J Clin Psychiatry. 2021 Nov 16;83(1):21m13918. doi: 10.4088/JCP.21m13918.

ABSTRACT

Background: Recent guidelines and systematic reviews suggest that disorder-specific psychotherapeutic interventions are the first choice in the treatment of borderline personality disorder (BPD). The aim of this study is to examine brain activity changes in BPD patients (DSM-5) who received a revised BPD-adapted interpersonal psychotherapy (IPT-BPD-R) compared with patients on the waiting list.

Methods: Forty-three patients with a BPD diagnosis (DSM-5) were randomly assigned to IPT-BPD-R (n = 22 patients) or the waiting list with clinical management (n = 21 patients) for 10 months. Both groups were tested before and after treatment with the Social and Occupational Functioning Assessment Scale (SOFAS), the Clinical Global Impressions-Severity of Illness scale (CGI-S), the Borderline Personality Disorder Severity Index (BPDSI), the Barratt Impulsiveness Scale-version 11 (BIS-11), and the Autobiographical Interview. Both groups underwent pre- and posttreatment functional magnetic resonance imaging (fMRI) testing. The fMRI task consisted of the presentation of resolved and unresolved life events compared to a neutral condition. All structural and functional images were analyzed using Statistical Parametric Mapping 12 software, which interfaces with MATLAB. Clinical data were analyzed using analysis of variance for repeated measures. Patients were recruited between September 2017 and April 2019.

Results: In clinical results, for the 4 rating scales, a significant between-subject effect was found in favor of the IPT-BPD-R-treated group (CGI-S: P = .011; BPDSI: P = .009; BIS-11: P = .033; SOFAS: P = .022). In fMRI results, posttreatment versus pretreatment for the contrast unresolved life event versus neutral condition showed significantly decreased right temporoparietal junction (rTPJ: x = 45, y = -51, z = 36) (P = .043) and right anterior cingulate cortex (rACC: x = -4, y = 37, z = 8) activity (P = .021).

Conclusions: IPT-BPD-R appears to be effective in treating BPD symptoms, and these clinical effects are reflected in the functional changes observed with fMRI. Brain areas that showed modulation of their activity are the rTPJ and rACC, which are involved in mentalization processes that are fundamental to BPD pathology.

Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) code: ACTRN12619000078156.

PMID:34792871 | DOI:10.4088/JCP.21m13918

Top Cogn Sci. 2021 Nov 18. doi: 10.1111/tops.12580. Online ahead of print.

ABSTRACT

My first 30-odd years of research in cognitive science has been driven by an attempt to balance two facts about human thought that seem incompatible and two corresponding ways of understanding information processing. The facts are that, on one hand, human memories serve as sophisticated pattern recognition devices with great flexibility and an ability to generalize and predict as long as circumstances remain sufficiently familiar. On the other hand, we are capable of deploying an enormous variety of representational schemes that map closely onto articulable structure in the world and that support explanation even in unfamiliar circumstances. The contrasting ways of modeling such processes involve, first, more and more sophisticated associative models that capture progressively higher-order statistical structure and, second, more powerful representational languages for other sorts of structure, especially compositional and causal structure. My efforts to rectify these forces have taken me from the study of memory to induction and category knowledge to causal reasoning. In the process, I have consistently appealed to dual systems of thinking. I have come to realize that a key reason for our success as cognizers is that we rely on others for most of our information processing needs; we live in a community of knowledge. We make use of others both intuitively-by outsourcing much of our thinking without knowing we are doing it-and by deliberating with others.

PMID:34792846 | DOI:10.1111/tops.12580

J Magn Reson Imaging. 2021 Nov 18. doi: 10.1002/jmri.27999. Online ahead of print.

ABSTRACT

BACKGROUND: The associations between diffusion kurtosis imaging (DKI)-derived parameters and clinical prognostic factors of breast cancer have not been fully evaluated; this knowledge may have implications for outcome prediction and treatment strategies.

PURPOSE: To determine associations between quantitative diffusion parameters derived from DKI and diffusion-weighted imaging (DWI) and the prognostic factors and molecular subtypes of breast cancer.

STUDY TYPE: Retrospective.

POPULATION: A total of 383 women (mean age, 53.8 years; range, 31-82 years) with breast cancer who underwent preoperative breast MRI including DKI and DWI.

FIELD STRENGTH/SEQUENCE: A 3.0 T; DKI using a spin-echo echo-planar imaging (EPI) sequence (b values: 200, 500, 1000, 1500, and 2000 sec/mm² ), DWI using a readout-segmented EPI sequence (b values: 0 and 1000 sec/mm² ) and dynamic contrast-enhanced breast MRI.

ASSESSMENT: Two radiologists (J.Y.K. and H.S.K. with 9 years and 1 year of experience in MRI, respectively) independently measured kurtosis, diffusivity, and apparent diffusion coefficient (ADC) values of breast cancer by manually placing a regions of interest within the lesion. Diffusion measures were compared according to nodal status, grade, and molecular subtypes.

STATISTICAL TESTS: Kruskal-Wallis test, Mann-Whitney U test with Bonferroni correction, receiver operating characteristic (ROC) analysis, and multivariate logistic regression analysis. (Statistical significance level of P < 0.05).

RESULTS: All diffusion measures showed significant differences according to axillary nodal status and histological grade. Kurtosis showed significant differences among molecular subtypes. The luminal subtype (median 1.163) showed a higher kurtosis value compared to the HER2-positive (median 0.962) or triple-negative subtypes (median 1.072). ROC analysis for differentiating HER2-positive from luminal subtypes revealed that kurtosis yielded the highest area under the curve of 0.781. In multivariate analyses, kurtosis remained a significant factor associated with differentiation between HER2-positive and luminal (odds ratio [OR] = 0.993), triple-negative and luminal (OR = 0.995), and HER2-positive and triple-negative subtypes (OR = 0.994).

DATA CONCLUSION: Quantitative diffusion parameters derived from DKI and DWI are associated with prognostic factors for breast cancer. Moreover, DKI-derived kurtosis can help distinguish between the molecular subtypes of breast cancer.

EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: 3.

PMID:34792837 | DOI:10.1002/jmri.27999

J Magn Reson Imaging. 2021 Nov 18. doi: 10.1002/jmri.27995. Online ahead of print.

ABSTRACT

BACKGROUND: Automated segmentation using convolutional neural networks (CNNs) have been developed using four-dimensional (4D) flow magnetic resonance imaging (MRI). To broaden usability for congenital heart disease (CHD), training with multi-institution data is necessary. However, the performance impact of heterogeneous multi-site and multi-vendor data on CNNs is unclear.

PURPOSE: To investigate multi-site CNN segmentation of 4D flow MRI for pediatric blood flow measurement.

STUDY TYPE: Retrospective.

POPULATION: A total of 174 subjects across two sites (female: 46%; N = 38 healthy controls, N = 136 CHD patients). Participants from site 1 (N = 100), site 2 (N = 74), and both sites (N = 174) were divided into subgroups to conduct 10-fold cross validation (10% for testing, 90% for training).

FIELD STRENGTH/SEQUENCE: 3 T/1.5 T; retrospectively gated gradient recalled echo-based 4D flow MRI.

ASSESSMENT: Accuracy of the 3D CNN segmentations trained on data from single site (single-site CNNs) and data across both sites (multi-site CNN) were evaluated by geometrical similarity (Dice score, human segmentation as ground truth) and net flow quantification at the ascending aorta (Qs), main pulmonary artery (Qp), and their balance (Qp/Qs), between human observers, single-site and multi-site CNNs.

STATISTICAL TESTS: Kruskal-Wallis test, Wilcoxon rank-sum test, and Bland-Altman analysis. A P-value <0.05 was considered statistically significant.

RESULTS: No difference existed between single-site and multi-site CNNs for geometrical similarity in the aorta by Dice score (site 1: 0.916 vs. 0.915, P = 0.55; site 2: 0.906 vs. 0.904, P = 0.69) and for the pulmonary arteries (site 1: 0.894 vs. 0.895, P = 0.64; site 2: 0.870 vs. 0.869, P = 0.96). Qs site-1 medians were 51.0-51.3 mL/cycle (P = 0.81) and site-2 medians were 66.7-69.4 mL/cycle (P = 0.84). Qp site-1 medians were 46.8-48.0 mL/cycle (P = 0.97) and site-2 medians were 76.0-77.4 mL/cycle (P = 0.98). Qp/Qs site-1 medians were 0.87-0.88 (P = 0.97) and site-2 medians were 1.01-1.03 (P = 0.43). Bland-Altman analysis for flow quantification found equivalent performance.

DATA CONCLUSION: Multi-site CNN-based segmentation and blood flow measurement are feasible for pediatric 4D flow MRI and maintain performance of single-site CNNs.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

PMID:34792835 | DOI:10.1002/jmri.27995

Vet Comp Oncol. 2021 Nov 18. doi: 10.1111/vco.12786. Online ahead of print.

ABSTRACT

Standardized veterinary neuroimaging response assessment methods for brain tumours are lacking. Consequently, a response assessment in veterinary neuro-oncology (RAVNO) system which uses the sum product of orthogonal lesion diameters on 1-image section with the largest tumour area, has recently been proposed. In this retrospective study, 22 pre-treatment magnetic resonance imaging (MRI) studies from 18 dogs and four cats with suspected intracranial neoplasia were compared by a single observer to 32 post-treatment MRIs using the RAVNO system and two volumetric methods based on tumour margin or area delineation with HOROS and 3D Slicer software, respectively. Intra-observer variability was low, with no statistically significant differences in agreement index between methods (mean AI ± SD, 0.91 ± 0.06 for RAVNO; 0.86 ± 0.08 for HOROS; and 0.91 ± 0.05 for 3D slicer), indicating good reproducibility. Response assessments consisting of complete or partial responses, and stable or progressive disease, agreed in 23 out of 32 (72%) MRI evaluations using the three methods. The RAVNO system failed to identify changes in mass burden detected with volumetric methods in 6 cases. 3D Slicer differed from the other two methods in 3 cases involving cysts or necrotic tissue as it allowed for more accurate exclusion of these structures. The volumetric response assessment methods were more precise in determining changes in absolute tumour burden than RAVNO but were more time-consuming to use. Based on observed agreement between methods, low intra-observer variability, and decreased time constraint, RAVNO might be a suitable response assessment method for the clinical setting.

PMID:34792828 | DOI:10.1111/vco.12786