Tag: nevin manimala

Eur Spine J. 2023 Dec 16. doi: 10.1007/s00586-023-08066-9. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to explore the relationships between lumbar lordosis (LL) correction and improvement of postoperative global sagittal alignment and to establish corresponding linear regressions to predict the change in global tilt (GT) based on the corrected LL following adult spinal deformity (ASD) surgery.

METHODS: A total of 240 ASD patients who underwent lumbar correction were enrolled in this multicentre study. The following sagittal parameters were measured pre- and postoperatively: thoracic kyphosis (TK), LL, upper and lower LL (ULL and LLL), pelvic tilt (PT), sagittal vertical axis (SVA) and GT. The correlations among the changes in GT (△GT), SVA (△SVA), PT (△PT), TK (△TK), LL (△LL), ULL (△ULL) and LLL (△LLL) were assessed, and linear regressions were conducted to predict △GT, △SVA, △PT and △TK from △LL, △ULL and △LLL.

RESULTS: △LL was statistically correlated with △GT (r = 0.798, P < 0.001), △SVA (r = 0.678, P < 0.001), △PT (r = 0.662, P < 0.001) and △TK (r = – 0.545, P < 0.001), and the outcomes of the linear regressions are: △GT = 3.18 + 0.69 × △LL (R² = 0.636), △SVA = 4.78 + 2.57 × △LL (R² = 0.459), △PT = 2.57 + 0.34 × △LL (R² = 0.439), △TK = 7.06-0.43 × △LL (R² = 0.297). In addition, △LLL had more correlations with △GT, △SVA and △PT, while △ULL had more correlations with △TK.

CONCLUSION: Surgical correction of LL could contribute to the restoration of global sagittal morphology following ASD surgery. These models were established to predict the changes in sagittal parameters, in particular △GT, determined by △LL, which has not been previously done and may help to customize a more precise correction plan for ASD patients.

PMID:38104044 | DOI:10.1007/s00586-023-08066-9

Arch Gynecol Obstet. 2023 Dec 16. doi: 10.1007/s00404-023-07313-0. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of acupressure on nausea and vomiting during pregnancy.

METHODS: PubMed, Embase, Springer, Web of Science, and the Cochrane Library were searched for all randomized controlled trials (RCT) of treating nausea and vomiting during pregnancy by acupressure from the inception date of database to July 31st, 2023. Study selection, data extraction, and risk of bias assessment were conducted independently by researchers. The methodological quality of included studies was evaluated by the Cochrane Collaboration’s bias risk assessment tool, meta-analysis by Stata 17.0 software, and publication bias by Begg’s test.

RESULTS: A total of 11 RCTs involving 1378 pregnant women were included in this review, which was assessed to be moderate quality. 10 RCTs involving 1298 pregnant women were assessed for the meta-analysis. The results revealed that acupressure showed significant difference on improvement in symptom score compared with sham acupressure (pooled MD, – 1.33; 95%CI [- 2.06, – 0.61]; P < 0.001) or control group (pooled MD, – 0.73; 95%CI [- 1.08, – 0.39]; P < 0.001), and incidence of effective rate compared with sham acupressure group (pooled RR, 1.78; 95%CI [1.03, 3.07]; P = 0.039). However, no statistical significance was found between acupressure and control group (pooled RR, 4.53; 95%CI [0.67, 30.48]; P = 0.120) on effective rate. On comparing acupressure with sham acupressure, there was no beneficial effect on preventing nausea and vomiting during pregnancy (pooled RR, 0.83; 95%CI [0.50, 1.38]; P = 0.476), shortening the duration of hospital stay (pooled MD, – 0.78; 95%CI [- 1.98, 0.41]; P = 0.199) and improving patient satisfaction (pooled RR, 1.36; 95%CI [0.47, 3.91]; P = 0.570). Begg’s test did not reveal any publication bias. Only one RCT reported minimal acupressure-related adverse events.

CONCLUSION: Acupressure may have potential favorable or encouraging effect on treating nausea and vomiting during pregnancy, but strong supportive data are not yet available. Well-designed and large-scale RCTs should be conducted for assessing and confirming the efficacy and safety of acupressure in nausea and vomiting during pregnancy.

PMID:38104041 | DOI:10.1007/s00404-023-07313-0

Updates Surg. 2023 Dec 16. doi: 10.1007/s13304-023-01723-0. Online ahead of print.

ABSTRACT

Improving the quality of lung cancer care at a cost that can be sustained is a hotly debated issue. High-risk, low-volume procedures (such as lung resections) are believed to improve significantly when centralised in high-volume centres. However, limited evidence exists to support volume requirements in lung cancer surgery. On the other hand, there was no evidence that the number of lung resections affected either the short-term perioperative results or the long-term cost. Using data from an extensive nationwide registry, this study investigated the correlations between surgical volumes and selected perioperative outcomes. A retrospective analysis of a prospectively filled national registry that follows stringent quality assurance and security procedures was conducted to ensure data accuracy and security. Patients who underwent VATS lobectomy from 2014 to 2019 at the participating centres were included. Selected perioperative outcomes were reported. Total direct hospital cost is measured at discharge for hospitalisations with a primary diagnosis of lung cancer, hospital stay costs, and postoperative length of hospital stay after lobectomy. After the propensity score matched, centres were divided into three groups according to the surgical volume of the unit where VATS lobectomies were performed (high-volume centre: > 500 lobectomies; medium-volume centre: 200-500 lobectomies; low-volume centre: < 200 lobectomies). 11,347 patients were included and matched (low-volume center = 2890; medium-volume center = 3147; high-volume center = 2907). The mean operative time density plot (Fig. 1A) showed no statistically significant difference (p = 0.67). In contrast, the density plot of the harvested lymph nodes (Fig. 1B) showed significantly higher values in the high-volume centres (p = 0.045), albeit without being clinically significant. The adjusted rates of any and significant complications were higher in the low-volume centre (p = 0.034) without significantly affecting the length of hospital stay (p = 0.57). VATS lobectomies for lung cancer in higher-volume centres seem associated with a statistically significantly higher number of harvested lymph nodes and lower perioperative complications, yet without any significant impact in terms of costs and resource consumption. These findings may advise the investigation of the learning curve effect in a complete economic evaluation of VATS lobectomy in lung cancer. Fig. 1 The mean operative time density plot showed no statistically significant difference (p = 0.67).

PMID:38103167 | DOI:10.1007/s13304-023-01723-0

Obes Surg. 2023 Dec 16. doi: 10.1007/s11695-023-06971-y. Online ahead of print.

ABSTRACT

PURPOSE: Many individuals search for obesity treatment options on the Internet. We aimed to analyze the popularity of pharmacological and surgical obesity treatment methods searched by Google users.

MATERIAL AND METHODS: We used Google Trends to identify topics representing the following: recommended surgical methods (n = 9), recommended pharmacological methods (n = 10), and not recommended pharmacological methods (n = 34). The data was generated for 2004-2022 and 2020-2022. Relative search volume (RSV) was adjusted using “Gastric bypass surgery” as a benchmark. We analyzed the geographical and temporal trends of the topics.

RESULTS: In 2004-2022, the topics representing recommended surgical methods numerically gained the most popularity among Google users, but in 2020-2022 the recommended drugs exceeded other obesity treatment methods. The most popular individual topics since 2004 were “flaxseed,” “Spirulina,” “Carnitine,” “Bariatric surgery,” and “Orlistat.” The most dynamic increases of searches since 2004 were observed for “Sleeve gastrectomy,” “Curcumin,” “Psyllium,” and “Bupropion/Naltrexon.” Since 2018, topics representing GLP-1 analogs such as “Semaglutide” and “Saxenda” revealed exponential increases in RSV, causing that “Semaglutide” to become the fourth most popular topic in 2020-2022.

CONCLUSIONS: Google users across the world were the most interested in topics representing bariatric surgery, but recently recommended drugs for the treatment of obesity gained the most attention. The most popular individual topics were dietary supplements with uncertain effects on weight loss.

PMID:38103152 | DOI:10.1007/s11695-023-06971-y

Odontology. 2023 Dec 16. doi: 10.1007/s10266-023-00878-x. Online ahead of print.

ABSTRACT

Despite the success of monolithic zirconia restorations (MZ), metal-ceramic restorations (MC) are still considered the gold standard for fixed prosthetics in the posterior region. This systematic review and meta-analysis aimed to compare the fracture strengths of single-unit MC and MZ in the molar region. This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA, 2020) statement. All articles were searched from the PubMed and Web of Science databases until November 18, 2022. All in vitro studies evaluating the fracture strengths of MC and MZ were also included. Statistical analysis was performed with the Comprehensive Meta-Analysis program, with a significance level of 0.05. Out of 753 studies, five were selected. The fracture strengths of MZ and MC did not show any statistically significant difference for both tooth (95% CI – 1.589: 2.118, p = 0.779, z = 0.280) and implant (95% CI – 2.215: 2.191, p = 0.992 z = – 0.010) supported restorations. However, different abutment materials (p < 0.001) and aging treatments (p < 0.001) in tooth-supported restorations displayed a significant statistical difference. Additionally, a significant difference was also observed in subgroup analysis considering different cements (p = 0.001) and load speeds (p = 0.001) in implant-supported restorations. Fracture strengths of MZ and MC did not show a significant statistical difference in implant or tooth-supported single-unit posterior restorations. MZ may be a suitable alternative to MC in single-unit posterior restorations. The results should be interpreted with caution, as the included studies were in vitro.

PMID:38103151 | DOI:10.1007/s10266-023-00878-x

J Thromb Thrombolysis. 2023 Dec 16. doi: 10.1007/s11239-023-02921-8. Online ahead of print.

ABSTRACT

Our objectives were to measure long-term adherence to oral anticoagulants (OACs) in patients with atrial fibrillation (AF) and to identify patient factors associated with adherence. Using linked, population-based administrative data from British Columbia, Canada, an incident cohort of adults prescribed OACs for AF was identified. We calculated the proportion of days covered (PDC) as a time-dependent covariate for each 90-day window from OAC initiation until the end of follow-up. Associations between patient attributes and adherence were assessed using generalized mixed effect linear regression models. 30,264 patients were included. Mean PDC was 0.69 (SD 0.28) over a median follow-up of 6.7 years. 54% of patients were non-adherent (PDC < 0.8). After controlling for confounders, factors positively associated with adherence were number of drug class switches, history of stroke or transient ischemic attack, history of vascular disease, time since initiation, and age. Age > 75 years at initiation, polypharmacy (among VKA users only), and receiving DOAC (vs. VKA) were negatively associated with adherence. PDC decreased over time for VKA users and increased for DOAC users. Over half of AF patients studied were, on average, nonadherent to OAC therapy and missed 32% of their doses. Several patient factors were associated with higher or lower adherence, and adherence to VKA declined during therapy while DOAC adherence increased slightly over time. To min im ize the risk stroke, adherence-supporting interventions are needed for all patients with AF, particularly those aged > 75 years, those with prior stroke or vascular disease, VKA users with polypharmacy, and DOAC recipients.

PMID:38103148 | DOI:10.1007/s11239-023-02921-8

Eur Geriatr Med. 2023 Dec 16. doi: 10.1007/s41999-023-00900-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of occupational therapy on anxiety, depression, and psychological well-being in older adults.

METHODS: This study is a single-blind, randomized-controlled prospective experimental study conducted with 84 older adult individuals, 41 in the intervention group and 43 in the control group, in a nursing home. Occupational therapy was applied to the patients in the intervention group, and all patients were followed for a week. In the study, data were collected using the Participant Information Form, Geriatric Anxiety Scale, Psychological Well-Being Scale, and Geriatric Depression Scale.

RESULTS: The mean age of the participants was 68 years in the intervention group and 70 years in the control group. While 65.9% of the participants in the experimental group were male, 65.1% of the control group was male. The post-test anxiety scores of the participants were lower in the intervention group than in the control group (7.0 ± 4.2 vs. 16.7 ± 10.9) (p < 0.001). The post-test psychological well-being scores of the participants were higher in the intervention group than in the control group (47.9 ± 6.8 vs. 38.4 ± 6.5) (p < 0.001). There was no statistically significant difference between the depression scores of the intervention group and the control group (6.9 ± 3.7 vs. 6.2 ± 5.4) (p = 0.468).

CONCLUSIONS: In this study, it was determined that after occupational therapy was applied to older adults, their anxiety decreased and their psychological well-being increased, while there was no statistically significant difference in their depression levels. Occupational therapy, with a focus on decreasing anxiety, is a potential approach that can improve older adults’ health, psychological well-being, and coping skills.

GOV ID: NCT05576558.

PMID:38103144 | DOI:10.1007/s41999-023-00900-z

Biochem Genet. 2023 Dec 16. doi: 10.1007/s10528-023-10608-1. Online ahead of print.

ABSTRACT

Beclin 1 protein encoded by the BECN1 gene plays a critical role in the autophagy pathway which is utilized by the Hepatitis B virus (HBV) for its replication. HBV is known for the subversion of the host’s autophagy process for its multiplication. The aim of this study was to determine the role of BECN1 intronic variants in HBV susceptibility. Intronic region variant rs9890617 was analyzed using Human splicing finder v3.1 and was found to alter splicing signals. A total of 712 individuals (494 HBV infected and 218 healthy controls) were recruited in the study and genotyped by applying Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). Statistical analysis revealed that the mutant allele T of rs9890617 was significantly associated with the overall disease risk in the allelic model (OR 1.41; 95%CI 1.00-1.99, p = 0.04). On stratifying the data based on the different stages of HBV infection, the mutant genotype showed a significant association with the chronic group in allelic (OR 1.62; 95%CI 1.11-2.39, p = 0.01), dominant (OR 1.64; 95%CI 1.07-2.52, p = 0.02), and co-dominant (OR 1.55; 95%CI 1.00-2.40, p = 0.04) models. Overall, this is the first study regarding beclin 1 variant rs9890617 and we found a significant association of the mutant T allele with the genetic predisposition to HBV infection.

PMID:38103127 | DOI:10.1007/s10528-023-10608-1

Biochem Genet. 2023 Dec 16. doi: 10.1007/s10528-023-10600-9. Online ahead of print.

ABSTRACT

Systemic Lupus Erythematosus (SLE) is an autoimmune disorder characterized by autoantibody production and organ involvement. The role of toll-like receptor-7 in SLE is well established. Although genetic variations in the TLR-7 gene have been associated with an increased risk of developing SLE, the findings are not consistent. We performed a meta-analysis of previously published articles on four important single nucleotide polymorphisms in the TLR-7 gene (rs3853839, rs179008, rs179019, and rs179010) to reach a valid conclusion. Various literature databases, including PubMed, Science Direct, and Scopus, were scoured for eligible reports until May 10, 2023. GPower software v.3 was used to assess the power of individual reports included in the meta-analysis. Comprehensive Meta-analysis v3 software was used to perform all statistics. The publication biases in each genetic comparison model were investigated using funnel plots and Egger’s regression test. To test heterogeneity, Cochrane Q statistics, probability value and I² were used. Considering the predefined inclusion and exclusion criteria, the current study included a total of 10 eligible studies that included 15,472 SLE cases and 16,721 healthy controls. The meta-analysis revealed a significant association between TLR7 polymorphisms (rs179019 and rs179010) and susceptibility to SLE development. Other TLR7 polymorphisms (rs3853839 and rs179008), on the other hand, showed no significant association. Furthermore, the trial sequential analysis identified the need for additional case control studies for TLR-7 polymorphisms (rs3853839, rs179008, and rs179019) other than the rs179010 polymorphism. TLR7 variants for rs179010 and rs179019 are risk factor for the development of SLE. Further investigations are required to reach a valid conclusion.

PMID:38103124 | DOI:10.1007/s10528-023-10600-9

Clin Transl Oncol. 2023 Dec 16. doi: 10.1007/s12094-023-03359-3. Online ahead of print.

ABSTRACT

BACKGROUND: Small cell lung cancer (SCLC) is an extremely malignant subtype of lung cancer because of its high potential for metastases. Cardiac invasion of SCLC is a serious concern that may lead to systemic embolism or tract obstruction. It has aroused much concern that cardiovascular comorbidities may significantly affect the survival of SCLC patients and their treatment decisions.

METHODS: We consecutively recruited 772 small cell lung cancer (SCLC) patients between January 2011 and December 2018 from 4 cancer specialty hospitals in China. Only newly diagnosed primary cancer inpatients were included. Univariable and multivariable adjusted Cox proportional hazard models were conducted to evaluate the risk factors associated with mortality. Hazard ratios (HRs) for mortality and corresponding 95% confidence intervals (95% CIs) were calculated.

RESULTS: The prevalence of cardiovascular diseases (CVDs) was 34.6% in all SCLC patients. Log-rank analysis presented statistically significant differences in median survival time (MST) between patients with CVD and without CVD in all SCLC patients (9.0 months vs. 15.0 months, P = 0.005) and patients with chemotherapy only (12.0 months vs. 18.0 months, P = 0.048). Pericardial effusion (HR 1.671, 95% CI 1.082-2.580, P = 0.021) and heart failure (HR 1.752, 95% CI 1.290-2.379, P < 0.001) were independent risk factors associated with mortality in all SCLC patients. VTE is related to poorer prognosis in patients with chemotherapy only (HR 5.558, 95% CI 1.335-23.135, P = 0.018) and chemoradiotherapy (HR 3.057, 95% CI 1.270-7.539, P = 0.013).

CONCLUSIONS: Comprehensive management of CVD comorbidities is of vital importance for the long-term prognosis of SCLC patients.

PMID:38103121 | DOI:10.1007/s12094-023-03359-3