Nevin Manimala

Radiol Med. 2022 Sep 4. doi: 10.1007/s11547-022-01548-8. Online ahead of print.

ABSTRACT

PURPOSE: To develop a predictive model for liver metastases in patients with pancreatic ductal adenocarcinoma (PDAC) based on textural features of the primary tumor extracted by computed tomography (CT) images.

MATERIALS AND METHODS: Patients with a pathologically proved PDAC who underwent CT between December 2020 and January 2022 were retrospectively identified. Treatment-naïve patients were included. Sex, age, tumor size, vascular infiltration and 39 arterial and portal phase textural features were analyzed. The variables significantly correlated to tumor size according to the Pearson’s product-moment correlation test were excluded from analysis; the remaining variables were compared between metastatic (M +) and non-metastatic (M-) patients using Fisher’s or Mann-Whitney test. The features with a significant difference between groups were entered into a binomial logistic regression test to develop a predictive model for liver metastases.

RESULTS: This study included 220 patients. Eight variables (tumor size, arterial HU_MAX, arterial GLRLM_LRLGE, arterial GLZLM_SZHGE, arterial GLZLM_LZLGE, portal GLCM_CORRELATION, portal GLRLM_LRLGE, and portal GLZLM_SZHGE) were significantly different between groups. The logistic regression model was statistically significant (χ² = 81.6, p < .001) and correctly classified 80.9% of cases. Sensitivity, specificity, positive and negative predictive values of the model were 58.6%, 91.3%, 75.9% and 82.5%, respectively. The area under the ROC curve of the model was 0.850 (95% CI, 0.793-0.907). Tumor size, arterial HU_MAX, arterial GLZLM_SZHGE and portal GLCM_CORRELATION were significant predictors of the likelihood of liver metastases, with odds ratios of 1.1, 0.9, 1, and 1.49, respectively.

CONCLUSIONS: CT texture analysis of PDAC can identify features that may predict the likelihood of liver metastases.

PMID:36057929 | DOI:10.1007/s11547-022-01548-8

Int Ophthalmol. 2022 Sep 4. doi: 10.1007/s10792-022-02488-y. Online ahead of print.

ABSTRACT

PURPOSE: To examine whether there is a relationship between ocular pulse amplitude (OPA), intraocular pressure (IOP), and visual field (VF) deterioration among the patients diagnosed with aortic regurgitation (AR).

METHODS: Twenty-nine patients (average age of 62.06 ± 13.27 years) with AR diagnosis without glaucoma history as AR group and 32 healthy participants (average age 63.81 ± 6.42 years) as control group were included in the study. Routine ophthalmologic examination including VF test [mean deviation (MD), pattern standard deviation (PSD) and VF index (VFI) values were recorded], diurnal IOP and OPA measurements with Pascal dynamic contour tonometry (DCT) was conducted on the patients. VF deficits were classified by Glaucoma Staging System 2 (GSS 2) score.

RESULTS: Sixteen (50.0%) of 32 healthy subjects and 14 (48.3%) of 29 AR patients were female (p = 1.000). The measurement conducted at 15:30 among the diurnal IOP measurements performed with the Pascal DCT was found to be statistically significantly higher in the AR group (p = 0.009). While the MD and PSD values of the group diagnosed with AR were determined to be statistically significantly high, the VFI value was found to be significantly low. When the healthy cases and the patients diagnosed with AR were compared, it was observed that there was a statistically significant positive correlation in terms of the significant GSS 2 stage (p < 0.001).

CONCLUSION: Although there was no significant increase in IOP, VF deficits were detected in patients with AR. These VF pathologies may be due to the ocular perfusion disorder in AR. However, additional comprehensive studies that also examine perfusion are needed to further confirm this.

PMID:36057917 | DOI:10.1007/s10792-022-02488-y

Eur Spine J. 2022 Sep 4. doi: 10.1007/s00586-022-07374-w. Online ahead of print.

ABSTRACT

PURPOSE: To identify the ideal entry point for pediatric C2 pedicle screw and to obtain parameters of it for the indication of pediatric atlantoaxial fusion arthrodesis.

METHODS: The pediatric cervical CT images were reconstructed into the 3D digital models and the C2 vertebrae were separated. The location of ideal entry point and screw placement related linear and angular parameters were assessed on the 3D digital models.

RESULTS: A total of 214 pedicles from 107 C2 digital models were analyzed. The average entry point for C2 was 3.80 ± 2.78 mm medial to the lateral notch (LN) and 2.57 ± 1.70 mm superior to the LN. The average pedicle diameter (PD) was 6.02 ± 1.31 mm, and the average pedicle screw length (PSL) was 25.63 ± 3.46 mm. Statistical differences were found between different sex for PD and PSL (P < 0.05). As patient age increases, using the most lateral and inferior edge of the lateral mass as a reference marker, the entry point tends to move medial and cephalad, when using the LN as a reference marker, the entry point tends to move medial and slightly caudad. Univariate linear regression analysis suggested that these linear parameters were associated with age (P < 0.01).

CONCLUSION: In this study, we found that the measurement results of C2 pedicle screw varied based on sex, laterality, and ages for children younger than 18 years. The entry point of the screws facilitating ideal trajectory tends to change in a linear way as a function of age. This information helps the surgeon to establish the specific anatomy related to C2 pedicle screw placement to facilitate fixation in the pediatric patients.

PMID:36057908 | DOI:10.1007/s00586-022-07374-w

World J Urol. 2022 Sep 4. doi: 10.1007/s00345-022-04108-x. Online ahead of print.

ABSTRACT

PURPOSE: Evaluate the percentage of patients with prostate cancer treated with luteinizing hormone-releasing hormone analogues (LHRHa) that develop castration resistance after a follow-up period of 3 years. The secondary objective is to evaluate the variables potentially related to the progression to castration resistant prostate cancer (CRPC).

METHODS: A post-authorization, nation-wide, multicenter, prospective, observational, and longitudinal study that included 416 patients treated with LHRHa between 2012 and 2017 is presented. Patients were followed for 3 years or until development of CRPC, thus completing a per-protocol population of 350 patients. A Cox regression analysis was carried out to evaluate factors involved in progression to CRPC.

RESULTS: After 3 years of treatment with LHRHa 18.2% of patients developed CRPC. In contrast, in the subgroup analysis, 39.6% of the metastatic patients developed CRPC, compared with 8.8% of the non-metastatic patients. The patients with the highest risk of developing CRPC were those with a nadir prostate-specific antigen (PSA) > 2 ng/ml (HR 21.6; 95% CI 11.7-39.8; p < 0.001) and those receiving concomitant medication, most commonly bicalutamide (HR 1.8; 95% CI 1-3.1, p = 0.0431).

CONCLUSIONS: The proportion of metastatic patients developing CRPC after 3 years of treatment with LHRHa is consistent with what has been previously described in the literature. In addition, this study provides new findings on CRPC in non-metastatic patients. Concomitant medication and nadir PSA are statistically significant predictive factors for the time to diagnosis of CRPC, the nadir PSA being the strongest predictor.

PMID:36057895 | DOI:10.1007/s00345-022-04108-x

Biotechnol Lett. 2022 Sep 4. doi: 10.1007/s10529-022-03297-0. Online ahead of print.

ABSTRACT

Ergosterol as a primary metabolite and precursor of vitamin D2, is the most plentiful mycosterols in fungal cell membrane. Process optimization to increase the yield and productivity of biological products is a topic of interest. Ultrasonic waves have many applications in biotechnology, like cell disruption, and enhancement of primary and secondary metabolites production. This study disclosed an optimal condition for ultrasound-assisted production (UAP) of ergosterol from Penicillium brevicompactum MUCL 19,011 using L₉ Taguchi statistical method. The intensity (IS), time of sonication (TS), treatment frequency (TF), and number of days of treatment (DT) were allocated to study the effects of ultrasound on ergosterol production. The results were analyzed using Minitab version 19. The maximum ergosterol, 11 mg/g cell dry weight (CDW), was produced on the tenth day while all factors were at a low level. The days of treatment with a contribution of 45.48% was the most significant factor for ergosterol production. For the first time, this study revealed the positive effect of ultrasound on the production of ergosterol. Ergosterol production increased 73% (4.63 mg/g CDW) after process optimization. Finally, a mathematical model of ultrasound factors with a regression coefficient of R² = 0.978 was obtained for the ergosterol production during ultrasound treatment.

PMID:36057882 | DOI:10.1007/s10529-022-03297-0

West Afr J Med. 2022 Aug 31;39(8):800-807.

ABSTRACT

BACKGROUND: With the global increase in chronic wounds and the paucity of studies on patient experiences at wound care facilities, we assessed the factors associated with satisfaction with wound care services among patients or their caregivers in a Northwest Nigerian outpatient setting.

METHODS: Participants were systematically selected from patients or their caregivers attending the General Outpatient Clinic of Aminu Kano Teaching Hospital, Kano, for wound dressing. A structured self-administered questionnaire was used to obtain information regarding their sociodemographic and clinical characteristics and satisfaction with service domains. Data were analyzed using descriptive and inferential statistical methods.

RESULTS: There were 170 participants. Their mean age was 31.9±11.4 years, and they were mainly female (55.3%). The overall satisfaction rate was 85.9% (146/170); however, 51.8% and 55.3% of participants were dissatisfied with the advice on home wound care and waiting time, respectively. Employment status, wound location, having sickle cell disease, needing a wheelchair to reach the wound dressing room and perceived availability of a wheelchair were associated with overall satisfaction (P<0.05). The predictors of overall satisfaction were chronic wounds, wound in areas other than the lower limbs/buttocks, and perceived availability of wheelchairs.

CONCLUSION: The overall satisfaction rate was high despite service gaps. However, future improvement in patient satisfaction will require addressing challenges such as the waiting time before wound dressing, equipment (e.g., wheelchairs), and staffing.

PMID:36057862

J Esthet Restor Dent. 2022 Sep 4. doi: 10.1111/jerd.12960. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the color stability, translucency, and biaxial flexural strength (BFS) of differently glazed advanced lithium disilicate (ALDS) with those of lithium disilicate (LDS) and zirconia-reinforced lithium silicate (ZLS) after coffee thermocycling.

MATERIALS AND METHODS: Forty disk-shaped specimens were prepared from three lithium silicate based materials (CEREC Tessera, ALDS; IPS e.max CAD, LDS; Vita Suprinity, ZLS). ALDS specimens were divided into two subgroups according to glazing procedures (reduced glaze duration, ALDS-S and normal glaze duration, ALDS-N), while LDS and ZLS specimens were crystallized and glazed. Color coordinate measurements were performed before and after coffee thermocycling. Color differences (ΔE₀₀ ) and relative translucency parameters (RTP) were calculated. Specimens were then subjected to BFS test. Statistical analysis was performed by using 1- (ΔE₀₀ and BFS) and 2-way (RTP) ANOVA tests (α = 0.05).

RESULTS: ΔE₀₀ values of tested materials were similar (df = 3, F = 0.150, p = 0.929). Two-way ANOVA showed the significant effect of material type, coffee thermocycling, and the interaction between these parameters on RTP values (p < 0.001). Both before and after thermocycling, LDS had the highest (p ≤ 0.001) and ZLS had the lowest (p < 0.001) RTP values, while ALDS-N had higher RTP than ALDS-S (p ≤ 0.001). Among tested materials, only LDS had similar RTP values before and after thermocycling (p = 0.865) as the other materials had lower RTP values after thermocycling (p < 0.001). ALDS-N had higher BFS values than ALDS-S (p = 0.005), while LDS had similar values to ALDS specimens (p ≥ 0.201). ZLS had the highest BFS (p ≤ 0.007).

CONCLUSIONS: ALDS had comparable values to those of other materials. However, reduced glazing duration resulted in decreased translucency and BFS of ALDS.

CLINICAL SIGNIFICANCE: ALDS may be an appropriate restorative material for those patients with increased coffee consumption considering its color stability and ability to maintain translucency, particularly when glazed by using a conventional porcelain furnace.

PMID:36057856 | DOI:10.1111/jerd.12960

Pest Manag Sci. 2022 Sep 4. doi: 10.1002/ps.7165. Online ahead of print.

ABSTRACT

BACKGROUND: Boron (B) and silicon (Si) are fundamental for brassica nutrition, and in some cases, they have potential as an insecticide. Plutella xylostella (L.) (Lepidoptera: Plutellidae), one of the most economically important agricultural pests, is difficult to control due to the resistance to insecticides and the absence of alternative control methods.

RESULTS: Cauliflower leaves sprayed with Si and B showed a higher concentration of the benefic element and micronutrient, respectively. When evaluating the firmness of the cauliflower leaves, it was found that the plants with leaf sprayings of Si and B did not differ statistically from each other. However, they showed an increase in firmness, in relation to the plants of the control treatment. Leaf spraying of Si and B on cauliflower did not influence the number of eggs/female. The attractiveness index showed that both Si and B applications stimulated the presence of second instar larvae, being more stimulating in relation to the control treatment. However, the use of Si and B in isolation showed a positive result, since it caused high mortality in diamondback moth larvae compared to the control treatment.

CONCLUSION: The application of both foliar fertilizers positively affects the AI of the larvae, being attractive; however, both Si and B caused high mortality (~80%). The results showed that Si and B have the potential to control P. xylostella and serve as a basis for alternative pest management in brassica crops. This article is protected by copyright. All rights reserved.

PMID:36057848 | DOI:10.1002/ps.7165

J Clin Pharmacol. 2022 Sep 4. doi: 10.1002/jcph.2148. Online ahead of print.

ABSTRACT

Enarodustat (JTZ-951) is a hypoxia-inducible factor prolyl hydroxylase inhibitor that has been approved and marketed in Japan for anemic patients with chronic kidney disease (CKD). The pharmacometric approach was applied to assess the relationship between plasma concentrations of enarodustat and hemoglobin (Hb) levels, and to provide information regarding the optimal use of enarodustat in clinical practice by simulations based on the pharmacokinetic and pharmacodynamic (PK/PD) model that was developed. The PK/PD data of enarodusat obtained from Phase 2 and Phase 3 studies in Japanese CKD patients were well described by the models: a 1-comportment model with first-order absorption and elimination for PK, and a semi-mechanistic model based on transit compartment model for PD. Although several factors were identified as statistically significant covariates on the PK/PD of enarodustat, model-based simulations showed that none of them had clinically relevant impacts on the treatment effect (i.e., Hb levels) of enarodustat. Hence, enarodustat treatment provides the stable Hb control with the initial dose (hemodialysis dependent CKD: 4 mg/day, non-dialysis dependent CKD: 2 mg/day) and maintenance dose (1 to 8 mg/day) to the patients with varied demographic characteristics. This article is protected by copyright. All rights reserved.

PMID:36057843 | DOI:10.1002/jcph.2148

Clin Hemorheol Microcirc. 2022 Aug 27. doi: 10.3233/CH-221443. Online ahead of print.

ABSTRACT

BACKGROUND: Conventional ultrasound (US), which include grey-scale US and doppler US, is the first-line imaging modality for the evaluation of renal allograft; however, conventional US indicators have limitations.

OBJECTIVE: To explore the application value of shear-wave elastography (SWE) combined with monochrome superb microvascular imaging (mSMI) in renal allograft chronic rejection (CR).

METHODS: From November 2021 to February 2022 in the Lanzhou University Second Hospital, the US features of 54 patients with renal allograft were retrospectively analyzed. Patients were categorized into two groups: stable group(n = 44) and CR group(n = 10), with clinical diagnosis as reference standard. The vascular index (VI) on mSMI and parenchymal stiffness were measured in the middle cortex of all renal allografts and receiver operating characteristic (ROC) curves were drawn to evaluate the feasibility of differentiation. Statistically significant US features and biochemical indicators such as creatinine were scored, and the results of the scores were analyzed by ROC curve.

RESULTS: The VI on mSMI of the stable group (49.5±2.0) was significantly greater than that of the CR group (33.8±5.9) (P = 0.028). There was a statistically significant difference in parenchymal stiffness between stable group (16.2kPa±1.2) and CR group (33.9kPa±6.6) (P = 0.027). The sensitivity was 90% and specificity was 81.8% of the scores in the differentiation of stable group from CR group (cut-off value, 2; P = 0.000).

CONCLUSION: SWE combined with mSMI may help differentiate stable renal allograft from renal allograft CR and have the potential application value in the diagnosis of renal allograft CR.

PMID:36057814 | DOI:10.3233/CH-221443