Nevin Manimala

J Stroke Cerebrovasc Dis. 2022 Feb 11;31(4):106347. doi: 10.1016/j.jstrokecerebrovasdis.2022.106347. Online ahead of print.

ABSTRACT

PURPOSE: Anticoagulation (AC) is the main preventive strategy for ischemic stroke in atrial fibrillation (AF) patients. We aim to investigate the association of prior AC with thrombus composition and clinical outcome in AF patients with acute ischemic stroke (AIS).

MATERIALS AND METHODS: From January 2019 to December 2020, consecutive AIS patients with AF treated with mechanical thrombectomy (MT) in our center were included in this analysis. Retrieved thrombi were stained with hematoxylin and eosin (H&E) and Martius Scarlet blue (MSB). The relative fractions of red blood cell (RBC), white blood cell (WBC), fibrin, and platelet were quantitatively analyzed. Procedural and clinical outcomes were compared between patients with and without prior AC.

RESULTS: A total of 133 patients were enrolled in this study, with 39 in AC group and 94 in non-AC (NAC) group. Thrombi in AC group contained more fibrins (36% vs 20%, p<0.001), more platelets (36% vs 24%, p<0.001) and fewer RBCs (25% vs 54%, p<0.001). No difference was detected in terms of successful recanalization evaluated with modified Thrombolysis in Cerebral Infarction scale (mTICI 2b-3, 97% vs 86%, p=0.065), functional independence at 90 days with modified Rankin Score (mRS 0-2, 44% vs 33%, p=0.246).

CONCLUSION: Thrombi retrieved from AF patients with prior AC contained more fibrins, more platelets and fewer RBCs compared with those of NAC patients. A trend of higher successful reperfusion rate was observed in AC patients but failed to reach statistical significance.

PMID:35158148 | DOI:10.1016/j.jstrokecerebrovasdis.2022.106347

Nurse Educ Today. 2022 Feb 8;111:105298. doi: 10.1016/j.nedt.2022.105298. Online ahead of print.

ABSTRACT

BACKGROUND: Although students are well prepared theoretically, they lack real-life practical skills because they have not faced an adequate number of emergencies such as neonatal resuscitation.

OBJECTIVES: This study was conducted with the objective of determining the impact of integrating serious game simulation (SGS) into neonatal resuscitation training on the neonatal resuscitation related knowledge, skills, satisfaction with training, and self confidence in learning of nursing students.

DESIGN: The study is a randomized controlled, pre-test post-test design and single-blind study.

SETTINGS AND PARTICIPANTS: This study was conducted on 90 undergraduate nursing students (SGS based training group = 45, control group = 45) enrolled in the fifth semester at the Faculty of Nursing.

METHODS: The students were allocated with simple randomization method to intervention and control groups. The training program prepared on the basis of neonatal resuscitation algorithm used a neonatal resuscitation serious game simulation method. At the same time, the serious game simulation method was used as a pre-test and post-test skill assessment tool. Support was obtained from a statistician in evaluation of the data and the data were analyzed using the SPSS (Statistical Package for Social Sciences) for Windows 25.0 program.

RESULTS: Post-test measurements indicated a statistically significant positive difference in the ventilation and chest compression performing skills of the intervention group compared to the control group (p = .011, p = .020, respectively). A considerable increase was found in the knowledge and skills level of both groups, after the neonatal resuscitation training (p < .05). The score averages of the Student Satisfaction and Self-Confidence in Learning Scale and its sub-dimensions were high for both groups.

CONCLUSIONS: It was concluded that the serious game simulation application used in neonatal resuscitation training was effective in raising the students’ ventilation and compression performing skills.

PMID:35158135 | DOI:10.1016/j.nedt.2022.105298

Cancer Treat Rev. 2022 Feb 7;104:102355. doi: 10.1016/j.ctrv.2022.102355. Online ahead of print.

ABSTRACT

Neuroblastoma survivors have an increased risk of unfavorable long-term health outcomes, of which developing subsequent neoplasms is one of the most serious. We aimed to provide an overview of the current knowledge on the risk of subsequent neoplasms in neuroblastoma survivors. We conducted a systematic literature search in Medline/Pubmed (01-01-1945-13-01-2022) to identify studies that reported on ≥ 100 neuroblastoma survivors and assessed subsequent neoplasms as an outcome. We identified 410 potentially eligible articles, of which we eventually included 13 reports. All articles described retrospective cohorts with sizes varying from 145 to 5,987 neuroblastoma survivors. Within these cohorts 0.7% – 17.2% of the survivors developed a subsequent neoplasm. A wide variety of types of subsequent malignant and non-malignant neoplasms were observed, of which thyroid carcinoma and acute myeloid leukemia were most frequently reported. The risk of developing a subsequent neoplasm was 2.8 to 10.4 times higher in neuroblastoma survivors than in the general population. Although no statistically significant risk factors for subsequent neoplasms were observed in multivariable analyses, high-risk group survivors, women and those treated with radiotherapy seemed to have a higher risk. In conclusion, the studies in this systematic review consistently show that neuroblastoma survivors are at elevated risk of developing subsequent neoplasms. Future research should further explore risk factors for subsequent neoplasms in neuroblastoma survivors, so future treatment protocols and follow-up care can be improved.

PMID:35158111 | DOI:10.1016/j.ctrv.2022.102355

Chem Asian J. 2022 Feb 14. doi: 10.1002/asia.202200076. Online ahead of print.

ABSTRACT

A halogenated bowl-shaped guest, corannulene, was encapsulated in a cylindrical host, [4]cyclochrysenylene, to form a bowl-in-tube complex, which mimicked supramolecular complexes between bowl guests and carbon nanotubes. As was the case with carbon nanotubes, the cylindrical space of [4]cyclochrysenylene trapped multiple corannulene molecules in an array, and 1:2 complexes were commonly obtained with the corannulene guests with various halogen substituents (F, Cl, Br and I). Careful statistical analyses of isothermal titration calorimetry titration data succeeded in revealing the stoichiometry, and the molecular structures of the 1:2 complexes were further clarified by X-ray crystallographic analyses. Two fluorinated corannulene guests were stacked perpendicular to the cylinder axis, while two chlorinated guests were stacked with inclined orientations. The structural difference resulted in a large difference in the cooperativity of the two-stage association in solution: fluorinated corannulene guests showed negative cooperativity for the 1:2 complexation, and the other, larger halogenated corannulene guests showed positive cooperativity.

PMID:35156775 | DOI:10.1002/asia.202200076

Epilepsia Open. 2022 Feb 14. doi: 10.1002/epi4.12585. Online ahead of print.

ABSTRACT

Studies of epilepsy surgery outcomes are often small and thus underpowered to reach statistically valid conclusions. We hypothesized that ordinal logistic regression would have greater statistical power than binary logistic regression when analyzing epilepsy surgery outcomes. We reviewed 10 manuscripts included in a recent meta-analysis which found that mesial temporal sclerosis (MTS) predicted better surgical outcome after a stereotactic laser amygdalohippocampectomy (SLAH). We extracted data from 239 patients from eight studies which reported four discrete Engel surgical outcomes after SLAH, stratified by the presence or absence of MTS. The rate of freedom from disabling seizures (Engel I) was 64.3% (110/171) for patients with MTS compared to 44.1% (30/68) without MTS. The statistical power to detect MTS as a predictor for better surgical outcome after a SLAH was 29% using ordinal regression, which was significantly more than the 13% power using binary logistic regression (paired t-test, p<0.001). Only 120 patients are needed to achieve 80% power to detect MTS as a predictor using ordinal regression, compared to 210 patients that are needed to achieve 80% power using binary logistic regression. Ordinal regression should be considered when analyzing ordinal outcomes (such as Engel surgical outcome), especially for datasets with small sample sizes.

PMID:35156772 | DOI:10.1002/epi4.12585

J Cosmet Dermatol. 2022 Feb 14. doi: 10.1111/jocd.14845. Online ahead of print.

ABSTRACT

INTRODUCTION: Botulinum toxin A (BoNT-A) has been increasingly used in the cosmetic dermatology daily routine. The treatment areas of BoNT-A are glabellar lines, forehead wrinkles, periorbital lines (crow’s feet), eyebrow lifting, perioral lines, platysmal bands, masseter hyperthrophy and hyperhydrosis. The aim of this study was to reveal the epidemiologic characteristics of the patients treated with BoNT-A and the frequencies of treatment areas.

PATIENT AND METHODS: The patients were grouped into five categories: facial wrinkles, platysmal bands, masseter hypertrophy, axillary hyperhydrosis and palmoplantar hyperhydrosis. Each patient received either onabotulinum toxin-A (diluted with 2 cc saline) or abobotulinum toxin-A (diluted with 3 cc saline) treatment. The patients’ age, gender and the total numbers of treatment received in each area were noted. SPSS version 21 was used for the statistical analysis.

RESULTS: A total of 1614 patients were included: 165 (6.5%) male and 1509 (93.5%) female. There is no difference between genders in terms of treatment area. (p=0.855). The number of treatment sessions is independent of the patients gender. (p=0.703). The mean age of the patients was 46.6 years. There is a relationship between the patients age and treatment area (sig 0.000). There is no relationship between the number of repetitive treatments and the patient’s age (p=0.081). The number of repetitive treatments is dependent to the treatment area (p< 0.001).

CONCLUSION: Facial wrinkles, platysmal bands and masseter hypertrophy are the most commonly treated areas. The treatment area is dependent on the age as platysmal bands are more commonly treated in older patients, however no relationship between gender and treatment area was found. BoNT-A treatment for hyperhydrosis is not as commonly repeated as for that of cosmetic concerns.

PMID:35156765 | DOI:10.1111/jocd.14845

J Cosmet Dermatol. 2022 Feb 14. doi: 10.1111/jocd.14848. Online ahead of print.

ABSTRACT

OBJECTIVE: Vitiligo is a common dermatological disease of unknown cause and progressing with depigmentation and affects approximately 1% of the world population. In the study, we aimed to compare plateletcrit (PCT), mean platelet volume (MPV), platelet (PLT), and thyroid-stimulating hormone (TSH) values in vitiligo patients.

MATERIAL AND METHODS: We retrospectively evaluated the medical data of 100 patients who were admitted to the dermatology outpatient clinic between January 2020 and December 2021 with a diagnosis of vitiligo. The control group was retrospectively constituted from medical records of 190 healthy individuals. PCT, MPV, PLT, and TSH levels of both groups were compared statistically.

RESULTS: A total of 190 participants (100 vitiligo patients and 90 healthy volunteers) were included in the study. The mean age of the patient group was 38.62±1.62, while the mean age of the control group was 41.52±1.54. There were no differences between the two groups in terms of age and gender. It was found that the mean MPV value in the patient group was lower than the control group (p=0.00). PLT and PCT values were significantly higher in the patient group than the control group (p=0.00, p=0.01, respectively). There was no statistically significant difference between the two groups in terms of TSH (p>0.05). A negative correlation between MPV and PLT values in the patient group (r=-0.218, p=0.029), and a negative correlation between MPV and TSH (r=-0.218, p=0.029). -0.230, p=0.021).

CONCLUSION: In the study, a comparison of the PCT, MPV, and PLT levels showed a difference between both groups, but no differences in TSH levels. To clarify these results, comprehensive studies with more samples are needed.

PMID:35156762 | DOI:10.1111/jocd.14848

J Magn Reson Imaging. 2022 Feb 14. doi: 10.1002/jmri.28113. Online ahead of print.

ABSTRACT

BACKGROUND: There has been a growing interest in exploring the applications of stretched-exponential (SEM) and intravoxel incoherent motion (IVIM) models of diffusion-weighted imaging (DWI) in breast imaging, with the focus on differentiation of breast lesions. However, the use of SEM and IVIM models to predict early response to neoadjuvant chemotherapy (NACT) has received less attention.

PURPOSE: To investigate the value of monoexponential, SEM, and IVIM models to predict early response to NACT in patients with primary breast cancer.

STUDY TYPE: Prospective.

POPULATION: Thirty-seven patients with primary breast cancer (aged 46 ± 11 years) due to undergo NACT.

FIELD STRENGTH/SEQUENCES: A 1.5-T MR scanner, T₁ -weighted three-dimensional spoiled gradient-echo, two-dimensional single-shot spin-echo echo-planar imaging sequence (DWI) at six b-values (0-800 s mm^-2 ).

ASSESSMENT: Tumor volume, apparent diffusion coefficient, tissue diffusion (D_t ), pseudo-diffusion coefficient (D_p ), perfusion fraction (f), distributed diffusion coefficient, and alpha (α) were extracted, following volumetric sampling of the tumors, at three time-points: pretreatment, post one and three cycles of NACT.

STATISTICAL TESTS: Mann-Whitney test, receiver operating characteristic (ROC) curve. Statistical significance level was P < 0.05.

RESULTS: Following NACT, 17 patients were determined to be pathological responders and 20 nonresponders. Tumor volume was significantly larger in nonresponders at each MRI time-point and demonstrated reasonable performance in predicting response (area under the ROC curve [AUC] = 0.83-0.87). No significant differences between groups were found in the diffusion coefficients at each time-point (P = 0.09-1). The parameters α (SEM), f, and f × D_p (IVIM) were able to differentiate between response groups after one cycle of NACT (AUC = 0.73, 0.72, and 0.74, respectively).

CONCLUSION: Diffusion coefficients derived from the monoexponential, SEM, and IVIM models did not predict pathological response. However, the IVIM-derived parameters f and f × D_p and the SEM-derived parameter α were able to predict response to NACT in breast cancer patients following one cycle of NACT.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.

PMID:35156741 | DOI:10.1002/jmri.28113

J Magn Reson Imaging. 2022 Feb 14. doi: 10.1002/jmri.28106. Online ahead of print.

ABSTRACT

BACKGROUND: Magnetization transfer saturation (MTsat) imaging was developed to reduce T1 dependence and improve specificity to myelin, compared to the widely used MT ratio (MTR) approach, while maintaining a feasible scan time. As MTsat imaging is an emerging technique, the reproducibility of MTsat compared to MTR must be evaluated.

PURPOSE: To assess the test-retest reproducibility of MTR and MTsat in the mouse brain at 9.4 T and calculate sample sizes potentially required to detect effect sizes ranging from 6% to 14%.

STUDY TYPE: Prospective.

SUBJECTS: Twelve healthy C57Bl/6 mice.

FIELD STRENGTH/SEQUENCE: 9.4 T; magnetization transfer imaging using FLASH-3D Gradient Echo; T2-weighted TurboRARE spin echo.

ASSESSMENT: All mice were scanned at two timepoints (5 days apart). MTR and MTsat maps were analyzed using mean region-of-interest (ROIs: corpus callosum [CC], internal capsule [IC], hippocampus [HC], cortex [CX], and thalamus [TH]), and whole brain voxel-wise analysis.

STATISTICAL TESTS: Bland-Altman plots were used to assess biases between test-retest measurements. Test-retest reproducibility was evaluated via between and within-subject coefficients of variation (bsCV and wsCV, respectively). Sample sizes required were calculated (significance level: 95%; power: 80%), given effect sizes ranging from 6% to 14%, using both between and within-subject approaches. Results were considered statistically significant at P ≤ 0.05.

RESULTS: Bland-Altman plots showed negligible biases between test-retest sessions (MTR: 0.0009; MTsat: 0). ROI-based and voxel-wise CVs revealed high reproducibility for both MTR (ROI-bsCV/wsCV: CC-4.5/2.8%; IC-6.1/5.2%; HC-5.7/4.6%; CX-5.1/2.3%; TH-7.4/4.9%) and MTsat (ROI-bsCV/wsCV: CC-6.3/4.8%; IC-7.3/5.1%; HC-9.5/6.4%; CX-6.7/6.5%; TH-7.2/5.3%). With a sample size of 6, changes on the order of 15% could be detected in MTR and MTsat, both between and within subjects, while smaller changes (6%-8%) required sample sizes of 10-15 for MTR, and 15-20 for MTsat.

DATA CONCLUSION: MTsat exhibited comparable reproducibility to MTR, while providing sensitivity to myelin with less T1 dependence than MTR. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 1.

PMID:35156740 | DOI:10.1002/jmri.28106

Ginekol Pol. 2022 Feb 14. doi: 10.5603/GP.a2021.0233. Online ahead of print.

ABSTRACT

OBJECTIVES: Proteinuria is one of the diagnostic criteria of preeclampsia (PE). Measurement of 24-hour urine protein is the gold standard method for detection of proteinuria in PE. The 24-hour urine sampling is time-consuming, and inconvenient. To evaluate the accuracy of protein/creatinine (P/C) ratio in detection of significant proteinuria ( > 1 g/24-hours urine) in PE.

MATERIAL AND METHODS: One hundred and ten (110) preeclamptic women were included in this study and admitted for blood pressure monitoring, 24-hour urine collection, fetal well-being assessment and spot urine sample for measuring of P/C ratio. After thorough history and clinical examination, routine antenatal investigations were done for the women included in the study according to the hospital protocol, and to excluded pre-existing chronic renal disease. Twenty-four-hour urine collection started on the morning following hospital admission. Spot urine samples were obtained shortly before the 24-hour urine collection for measuring of P/C ratio. Collected data statistically analyzed to evaluate the accuracy of P/C ratio in detection of significant proteinuria in PE.

RESULTS: The P/C ratio of 1.35 ± 2.54 had 94.4% sensitivity, 94.9% specificity, 97.1% positive predictive value (PPV), 90.2% negative predictive value (NPV), and 94.5% overall accuracy in detection of significant proteinuria ( > 1 g/24-hour urine) in PE.

CONCLUSIONS: The P/C ratio of 1.35 ± 2.54 had 94.4% sensitivity, 94.9% specificity, 97.1% PPV, 90.2% NPV, and 94.5% overall accuracy in detection of significant proteinuria ( > 1 g/24-hour urine) in PE. This study suggests the use of P/C ratio as an alternative to 24-hour urine protein to detect significant proteinuria in PE.

PMID:35156696 | DOI:10.5603/GP.a2021.0233