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Does the Timing of Radiosurgery after Grade 1 Meningioma Resection Affect Long-Term Outcomes?

Stereotact Funct Neurosurg. 2021 Jul 21:1-6. doi: 10.1159/000517427. Online ahead of print.

ABSTRACT

BACKGROUND: Meningiomas are the most common benign intracranial tumors. Gamma Knife® stereotactic radiosurgery (GKSRS) has become a preferred management for recurrent or residual meningiomas. This study focuses on the relationship between tumor control and the time interval between resection of a World Health Organization (WHO) grade 1 meningioma and GKSRS.

METHODS: This single institution retrospective analysis reviewed our experience in 238 patients who underwent GKSRS after a pathologically confirmed WHO grade 1 meningioma resection. The median follow-up was 7.4 years. The median aggregate tumor volume at GKSRS was 6 cm3 and a median margin dose of 13 Gy was utilized. Neurological symptoms were evident in 60% of patients at the time of procedure.

RESULTS: Overall actuarial tumor control rates achieved were 91.3% at 5 years, 83.4% at 10 years, and 76% at 15 years. There were 35 patients (15%) who developed tumor progression within or directly adjacent to the GKSRS treatment field. The median time until progression was 6.3 years. The duration between surgical intervention and GKSRS did not show statistical significance at 3 months (p = 0.9), 6 months (p = 0.8), 12 months (p = 0.5), or 24 months (p = 0.9). Fifteen patients (6%) had tumor progression at an anatomically distinct location outside the GKSRS target volume. Neurological symptomatic improvement was more likely with early radiosurgery intervention (p = 0.007).

CONCLUSION: Postoperative GKSRS was associated with excellent long-term tumor control for WHO grade 1 meningiomas, regardless of the interval after initial surgery. In addition, earlier radiosurgery was associated with superior symptom improvement.

PMID:34289489 | DOI:10.1159/000517427

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Qualitative Assessment of Medical Information on YouTube: A Multilingual Comparison of Common Urological Conditions

Urol Int. 2021 Jul 21:1-7. doi: 10.1159/000517292. Online ahead of print.

ABSTRACT

INTRODUCTION: Patients nowadays often search video-sharing platforms for online patient education materials. Since previous assessments of urological videos were limited to English, we systematically assessed the quality of videos on treatment of benign prostatic hyperplasia (BPH), prostate cancer (PCa), and urinary stone disease (USD) in 4 different languages on YouTube using validated instruments.

METHODS: The search for videos on YouTube addressing treatment options of BPH, PCa, and USD was performed in October 2020 in -English, French, German, and Italian. Assessed parameters included basic data (e.g., number of views), grade of misinformation, and reporting of conflicts of interest. Quality of content was analyzed using the validated DISCERN questionnaire. Data were analyzed using descriptive statistics.

RESULTS: A total of 240 videos (60 videos in each language) were analyzed. Videos on USD in English had the highest number of views (median views 271,878 [65,313-2,513,007]). The median overall quality of videos assessed showed a moderate quality (2.5-3.4 points out of 5 points for DISCERN item 16). Median total DISCERN score of all videos divided by language showed very similar results: English (39.75 points), French (38 points), German (39.5 points), and Italian (39 points). Comparing the different diseases, videos about BPH showed the highest median scores, especially in German language (median score 43.25 points).

CONCLUSIONS: Videos concerning the treatment of BPH, PCa, and USD have a low to moderate quality of content, with no differences seen between the languages assessed. These findings further support the notion of improved patient information materials on video platforms such as YouTube.

PMID:34289487 | DOI:10.1159/000517292

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Effects of Prosody Rehabilitation on Acoustic Analysis of Prosodic Features in Hearing-Impaired Children: A Randomized Controlled Trial

Folia Phoniatr Logop. 2021 Jul 21:1-17. doi: 10.1159/000516979. Online ahead of print.

ABSTRACT

BACKGROUND: The role of prosody in language acquisition and effective communication is documented in research. Nevertheless, rehabilitation of prosodic skills in children with hearing impairment using hearing aids or cochlear implants is relatively neglected compared to other speech and language areas.

OBJECTIVE: To detect the effect of prosodic rehabilitation using the adapted translated version of the “Prosody Treatment Program” on expression of prosodic features in Egyptian Arabic-speaking hearing-impaired school-age children fitted with hearing aids or cochlear implant devices in comparison to conventional auditory and language rehabilitation.

METHODS: This study was conducted on 34 children with sensorineural hearing loss in a randomized controlled trial design. Children were randomly divided into 2 groups, group A (cases) and group B (control), by block randomization. Both groups were initially evaluated for their prosodic skills using objective measures. Group A received rehabilitation for prosody using the Prosody Treatment Program for 1 h, once per week for 3 months, while group B received conventional auditory and language training and served as their control. Both groups were re-evaluated using the same protocol after 3 months of therapy.

RESULTS: A statistically significant improvement of most of the assessed prosodic parameters in group A was shown when comparing the pretherapy and posttherapy scores, as well as comparing between both studied groups after therapy.

CONCLUSIONS: Prosody is amenable to motor learning. The Prosody Treatment Program seems to be an effective rehabilitation tool in improving some prosodic skills of hearing-impaired children. Prosodic rehabilitation showed superiority to conventional auditory and language training in improving the expression of some prosodic features and pragmatic language skills.

PMID:34289481 | DOI:10.1159/000516979

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Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis

ORL J Otorhinolaryngol Relat Spec. 2021 Jul 21:1-5. doi: 10.1159/000514460. Online ahead of print.

ABSTRACT

INTRODUCTION: In China, nasal cannula oxygen therapy is typically humidified. However, it is difficult to decide whether to suspend nasal cannula oxygen inhalation after the nosebleed has temporarily stopped. Therefore, we conducted a preliminary investigation on whether the use of humidified nasal cannulas in our hospital increases the incidence of epistaxis.

METHODS: We conducted a survey of 176,058 inpatients in our hospital and other city branches of our hospital over the past 3 years and obtained information concerning their use of humidified nasal cannulas for oxygen inhalation, nonhumidified nasal cannulas, anticoagulant and antiplatelet drugs, and oxygen inhalation flow rates. This information was compared with the data collected at consultation for epistaxis during these 3 years.

RESULTS: No significant difference was found between inpatients with humidified nasal cannulas and those without nasal cannula oxygen therapy in the incidence of consultations due to epistaxis (χ2 = 1.007, p > 0.05). The same trend was observed among hospitalized patients using anticoagulant and antiplatelet drugs (χ2 = 2.082, p > 0.05). Among the patients with an inhaled oxygen flow rate ≥5 L/min, the incidence of ear-nose-throat (ENT) consultations due to epistaxis was 0. No statistically significant difference was found between inpatients with a humidified oxygen inhalation flow rate <5 L/min and those without nasal cannula oxygen therapy in the incidence of ENT consultations due to epistaxis (χ2 = 0.838, p > 0.05). A statistically significant difference was observed in the incidence of ENT consultations due to epistaxis between the low-flow nonhumidified nasal cannula and nonnasal cannula oxygen inhalation groups (χ2 = 18.428, p < 0.001). The same trend was observed between the 2 groups of low-flow humidified and low-flow nonhumidified nasal cannula oxygen inhalation (χ2 = 26.194, p < 0.001).

DISCUSSION/CONCLUSION: Neither high-flow humidified nasal cannula oxygen inhalation nor low-flow humidified nasal cannula oxygen inhalation will increase the incidence of recurrent or serious epistaxis complications; the same trend was observed for patients who use anticoagulant and antiplatelet drugs. Humidification during low-flow nasal cannula oxygen inhalation can prevent severe and repeated epistaxis to a certain extent.

PMID:34289467 | DOI:10.1159/000514460

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The effects of auricular acupressure on stress, anxiety, and depression of outpatient nurses in South Korea

Complement Ther Clin Pract. 2021 Jul 16;44:101447. doi: 10.1016/j.ctcp.2021.101447. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Outpatient nursing is an occupation with high emotional labor and job stress. The purpose of this study was to examine the effects of auricular acupressure on stress, anxiety, and depression of outpatient nurses.

MATERIALS AND METHODS: The study design was a randomized controlled trial. Participants were 54 outpatient nurses, divided into an experimental (n = 28) and a control group (n = 26). Auricular acupressure using vaccaria seeds was administered to the experimental group, while placebo auricular acupressure using vaccaria seeds was administered to the placebo group. Sessions continued for 5 weeks. Outcome measurements included blood tests such as cortisol and serotonin.

RESULTS: There was a statistically significant difference in depression scores (t = 3.111, p = 0.002) and serotonin levels (t = 6.304, p < 0.001) between the experimental and placebo groups. Auricular acupressure decreased depression scores, and the depression-related physiological index, serotonin, also changed significantly.

CONCLUSION: Auricular acupressure using vaccaria seeds was effective in decreasing depression in outpatient nurses.

PMID:34289443 | DOI:10.1016/j.ctcp.2021.101447

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Effect of almond hulls on the performance, egg quality, nutrient digestibility, and body composition of laying hens

Poult Sci. 2021 May 27;100(9):101286. doi: 10.1016/j.psj.2021.101286. Online ahead of print.

ABSTRACT

The objective of this study was to evaluate 2 varieties of almond hulls (prime and California type hulls) as an alternative feed ingredient on the performance, egg quality, nutrient digestibility, and body composition using a total of 100 23-week-old Hy-Line W36 hens. Treatments consisted of a control diet based on corn and soybean meal; T2 and T3 were formulated to contain 7.5 and 15% of prime hulls; and T4 and T5 contained 7.5 and 15% of California type hulls. Inclusion of prime hulls and California type hulls had no effects on feed intake, egg laying rate, and feed conversion ratio, but California type hulls at 7.5% decreased (P < 0.001) body weight gain compared to the control. Prime hulls at 7.5% and California type hulls at both levels improved (P ≤ 0.022) AMEn and N digestibility. Both prime hulls and California type hulls had no effects on egg size, specific gravity, Haugh unit, and percentages of yolk, albumen and shell, but yolk color appeared greener and less yellow (P ≤ 0.009) by prime hulls and less yellow (P = 0.001) by California type hulls. For body composition, prime hulls and California type hulls at both levels lowered (P ≤ 0.017) body fat, and California type hulls at 7.5% decreased (P = 0.001) lean weight. In summary, inclusion of prime hulls and California type hulls up to 15% had no negative effect on egg production and egg quality while reduced the body fat percentage and mass.

PMID:34289427 | DOI:10.1016/j.psj.2021.101286

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Immune mechanisms orchestrate tertiary lymphoid structures in tumors via cancer-associated fibroblasts

Cell Rep. 2021 Jul 20;36(3):109422. doi: 10.1016/j.celrep.2021.109422.

ABSTRACT

Tumor-associated tertiary lymphoid structures (TA-TLS) are associated with enhanced patient survival and responsiveness to cancer therapies, but the mechanisms underlying their development are unknown. We show here that TA-TLS development in murine melanoma is orchestrated by cancer-associated fibroblasts (CAF) with characteristics of lymphoid tissue organizer cells that are induced by tumor necrosis factor receptor signaling. CAF organization into reticular networks is mediated by CD8 T cells, while CAF accumulation and TA-TLS expansion depend on CXCL13-mediated recruitment of B cells expressing lymphotoxin-α1β2. Some of these elements are also overrepresented in human TA-TLS. Additionally, we demonstrate that immunotherapy induces more and larger TA-TLS that are more often organized with discrete T and B cell zones, and that TA-TLS presence, number, and size are correlated with reduced tumor size and overall response to checkpoint immunotherapy. This work provides a platform for manipulating TA-TLS development as a cancer immunotherapy strategy.

PMID:34289373 | DOI:10.1016/j.celrep.2021.109422

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Intravitreal anti-vascular endothelial growth factor treatment for inflammatory choroidal neovascularization in non-infectious uveitis

Am J Ophthalmol. 2021 Jul 18:S0002-9394(21)00376-7. doi: 10.1016/j.ajo.2021.07.010. Online ahead of print.

ABSTRACT

PURPOSE: To compare visual outcome and recurrence rates of eyes with non-infectious inflammatory CNV treated with or without anti-VEGF injections and immunosuppression.

DESIGN: Retrospective, non-randomized clinical study METHODS: : Participants: Patients with CNV secondary to non-infectious inflammatory causes who attended uveitis clinics at Moorfields Eye Hospital between January 2000 and April 2016. Data was gathered from the clinical notes of all subjects examined in clinic.

MAIN OUTCOME MEASURES: change in best corrected visual acuity (BCVA), mean time to CNV recurrence, moderate vision loss (MVL; ≤ 20/50), severe vision loss (SVL; ≤20/200).

RESULTS: A total of 166 patients (204 eyes) with non-infectious inflammatory CNV were included in this study with a median follow-up of 6.9 years (IQR: 2.9-11.7; 1652 eye-years). The mean BCVA at the time of CNV diagnosis was 0.38±0.05 logMAR (Snellen equivalent 20/47) in the eyes which received the first-line anti-VEGF treatment and 0.44±0.03 logMAR (Snellen equivalent 20/55) in the eyes on other treatment modalities (p=0.39). Eyes treated first with anti-VEGF (n=55) received the mean of 4.35±0.53 injections and showed a statistically significant improvement in vision at all time points (p<0.001) except for a 5-year visit (p=0.25). The rest of the eyes demonstrated no significant change in vision throughout follow-up (all p>0.05). At the final visit the mean BCVA was 0.26±0.11 logMAR (Snelllen equivalent 20/36) in the former and 0.35±0.06 logMAR (Snellen equivalent 20/44) in the latter. The mean time to CNV recurrence was 186±15.1 months and the risk was significantly reduced by treatment with oral corticosteroids (aHR=0.32, CI:0.17-0.59, p<0.001) or anti-VEGF injections (aHR=0.31, CI:0.18-0.52, p<0.001).

CONCLUSIONS: Eyes that developed inflammatory CNV were at risk of vision loss. Those receiving early anti-VEGF injections achieved a better visual outcome and had a reduced risk of CNV recurrence. Oral corticosteroids also had an effect reducing the risk of recurrence in eyes previously treated.

PMID:34289337 | DOI:10.1016/j.ajo.2021.07.010

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Chasing the Anchor: A Systematic Review and Meta-Analysis of Perceptual Anchoring Deficits in Developmental Dyslexia

J Speech Lang Hear Res. 2021 Jul 21:1-14. doi: 10.1044/2021_JSLHR-20-00533. Online ahead of print.

ABSTRACT

Purpose We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of the effect between perceptual anchoring and reading ability in typical and atypical (i.e., dyslexic) readers. Method We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860-2020), MEDLINE (Ovid, 1860-2019), EMBASE (Ovid, 1883-2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English language articles, and, at minimum, one experimental group identified as dyslexic-either by reading assessment at the time or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa Scale. Eight studies were included in this review and meta-analysis (n = 422 participants). Results The overall effect was negative, moderate, and statistically significant; g = -0.70, 95% confidence interval [-1.10, -0.29]: a negative effect size indicating less perceptual anchoring in dyslexic versus nondyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (7) = 17.03, prediction interval [-1.79, 0.40]. Conclusions Of the included studies, we find evidence for a moderate perceptual anchoring deficit in individuals with dyslexia. The primary limitation of the current review is the small number of included studies. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia.

PMID:34289307 | DOI:10.1044/2021_JSLHR-20-00533

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Risk factors of peritoneal metastasis in primary appendiceal tumor

Zhonghua Zhong Liu Za Zhi. 2021 Jul 23;43(7):806-809. doi: 10.3760/cma.j.cn112152-20200901-00784.

ABSTRACT

Objective: To investigate the risk factors of peritoneal metastasis in primary appendiceal tumor. Methods: The clinic data of 71 patients with primary appendiceal tumor admitted in the Sixth Affiliated Hospital of Sun Yat-sen University between Dec 2012 and Jan 2019 were enrolled retrospectively. Multivariate logistic regression analysis were carried out to evaluate the risk factors of appendiceal tumor with peritoneal metastasis. Results: Of the 71 patients, 33 were peritoneal metastasis (peritoneal metastasis group) and 38 were non-peritoneal metastasis (no peritoneal metastasis group). Twenty-one patients in the peritoneal metastasis group had increased preoperative cancer embryo antigen (CEA), while 3 cases in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Sixteen cases in peritoneal metastasis group had increased preoperative carbohydrate antigen 199, while only 2 cases in the non-peritoneal metastasis group, the difference was statistically significant (P<0.001). The pathological type of 30 cases in the peritoneal metastasis group was adenocarcinoma (including mucus adenocarcinoma and colon adenocarcinoma), while 12 cases of adenocarcinoma in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Twelve cases in the peritoneal metastasis group had lymph node metastasis, while 3 cases in the non-peritoneal metastasis group, the difference is statistically significant (P=0.003). Preoperative CEA elevation and pathological type is adenocarinoma were independent risk factors for peritoneal metastasis of appendiceal cancer (P<0.05). Conclusions: The propensity of peritoneal metastasis in primary appendiceal tumor is high and the outcome is poor. Patients with increased preoperative CEA, adenocarcinoma histopathology are more inclined to have peritoneal metastasis.

PMID:34289577 | DOI:10.3760/cma.j.cn112152-20200901-00784