Tag: nevin manimala

Med Eng Phys. 2023 Jul;117:103996. doi: 10.1016/j.medengphy.2023.103996. Epub 2023 May 18.

ABSTRACT

OBJECTIVES: A sub-analysis of the MC-PRIMA study was performed to compare the plan quality of stereotactic radiosurgery (SRS) to multiple brain metastases (MBM) between UK and other international centres.

METHODS AND MATERIALS: Six centres from the UK and nineteen from other international centres autoplanned using Multiple Brain Mets™ (AutoMBM; Brainlab, Munich, Germany) software for a five MBM study case from a prior planning competition that was originally organized by the Trans-Tasmania Radiation Oncology Group (TROG). Twenty-three dosimetric metrics and the resulting composite plan score per the TROG planning competition were compared between the UK and other international centres. Planning experience and planning time from each planner were recorded and statistically compared.

RESULTS: Planning experiences between two groups are equal. Except for mean dose to the hippocampus, all other 22 dosimetric metrics were comparable between two groups. The inter-planner variations in these 23 dosimetric metrics and the composite plan score were also statistically equivalent. Planning time is slightly longer in the UK group (mean = 86.8 min) with a mean difference of 50.3 min.

CONCLUSIONS: AutoMBM effectively achieves standardization of the plan quality of SRS to MBM within UK and further against the other international centres. Significant planning efficiency gain by AutoMBM both among the UK and other international centres may help to increase the capacity of SRS service by alleviating the clinical and technical loadings.

PMID:37331750 | DOI:10.1016/j.medengphy.2023.103996

Addiction. 2023 Jun 18. doi: 10.1111/add.16269. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Optimising smoking cessation (SC) referral strategies within lung cancer screening (LCS) could significantly reduce lung cancer mortality. This study aimed to measure acceptance of referral to SC support by either practitioner-referral or self-referral among participants attending a hospital-based lung health check appointment for LCS as part of the Lung Screen Uptake Trial.

DESIGN: Single-blinded two-arm randomised controlled trial.

SETTING: England.

PARTICIPANTS: Six hundred forty-two individuals ages 60 to 75 years, who self-reported currently smoking or had a carbon monoxide reading over 10 ppm during the lung health check appointment.

INTERVENTION AND COMPARATOR: Participants were randomised (1:1) to receive either a contact information card for self-referral to a local stop smoking service (SSS) (self-referral, n = 360) or a SSS referral made on their behalf by the nurse or trial practitioner (practitioner-referral, n = 329).

MEASUREMENTS: The primary outcome was acceptance of the practitioner-referral (defined as participants giving permission for their details to be shared with the local SSS) compared with acceptance of the self-referral (defined as participants taking the physical SSS contact information card to refer themselves to the local SSS).

FINDINGS: Half (49.8%) accepted the practitioner-made referral to a local SSS, whereas most (88.5%) accepted the self-referral. The odds of accepting the practitioner-referral were statistically significantly lower (adjusted odds ratio = 0.10; 95% confidence interval = 0.06-0.17) than the self- referral. In analyses stratified by group, greater quit confidence, quit attempts and Black ethnicity were associated with increased acceptance within the practitioner-referral group. There were no statistically significant interactions between acceptance by referral group and any of the participants’ demographic or smoking characteristics.

CONCLUSIONS: Among participants in hospital-based lung cancer screening in England who self-reported smoking or met a carbon monoxide cut-off, both practitioner-referral and self-referral smoking cessation strategies were highly accepted. Although self-referral was more frequently accepted, prior evidence suggests practitioner-referrals increase quit attempts, suggesting practitioner-referrals should be the first-line strategy within lung cancer screening, with self-referral offered as an alternative.

PMID:37331722 | DOI:10.1111/add.16269

Mult Scler Relat Disord. 2023 Jun 10;76:104827. doi: 10.1016/j.msard.2023.104827. Online ahead of print.

ABSTRACT

BACKGROUND: Fingolimod is indicated for the treatment of relapsing-remitting multiple sclerosis (RRMS) and also targets cardiovascular system due to receptors on cardiomyocytes. Results of previous studies are controversial for the effect of fingolimod in terms of ventricular arrhythmias. Index of cardio-electrophysiological balance (iCEB) is a risk marker for predicting malignant ventricular arrhythmia. There is no evidence on the effect of fingolimod on iCEB in patients with relapsing-remitting multiple sclerosis (RRMS). The aim of this study was to evaluate iCEB in patients with RRMS treated with fingolimod .

METHODS: A total of 86 patients with RRMS treated with fingolimod were included in the study. All patients underwent a standard 12-lead surface electrocardiogram at initiation of treatment and 6 h after treatment. Heart rate, RR interval, QRS duration, QT, QTc (heart rate corrected QT), T wave peak-to-end (Tp-e) interval, Tp-e/QT, Tp-e/QTc, iCEB (QT/QRS) and iCEBc (QTc/QRS) ratios were calculated from the electrocardiogram. QT correction for heart rate was performed using both the Bazett and Fridericia formulas. Pre-treatment and post-treatment values were compared.

RESULTS: Heart rate was significantly lower after fingolimod treatment (p< 0.001). While the post-treatment values of RR and QT intervals were significantly longer (p< 0.001) and post-treatment iCEB was higher (median [Q1-Q3], 4.23 [3.95-4.50] vs 4.53 [4.18-5.14]; p< 0.001), it was found that there was no statistically significant change in iCEB and other study parameters derived using QT after correcting for heart rate using both of two formulas.

CONCLUSIONS: In this study, it was found that fingolimod did not statistically significantly change any of the heart rate-corrected ventricular repolarization parameters, including iCEBc, and it is safe in terms of ventricular arrhythmia.

PMID:37331085 | DOI:10.1016/j.msard.2023.104827

Phys Med. 2023 Jun 16;112:102610. doi: 10.1016/j.ejmp.2023.102610. Online ahead of print.

ABSTRACT

PURPOSE: The use of topological metrics to derive quantitative descriptors from structural connectomes is receiving increasing attention but deserves specific studies to investigate their reproducibility and variability in the clinical context. This work exploits the harmonization of diffusion-weighted acquisition for neuroimaging data performed by the Italian Neuroscience and Neurorehabilitation Network initiative to obtain normative values of topological metrics and to investigate their reproducibility and variability across centers.

METHODS: Different topological metrics, at global and local level, were calculated on multishell diffusion-weighted data acquired at high-field (e.g. 3 T) Magnetic Resonance Imaging scanners in 13 different centers, following the harmonization of the acquisition protocol, on young and healthy adults. A “traveling brains” dataset acquired on a subgroup of subjects at 3 different centers was also analyzed as reference data. All data were processed following a common processing pipeline that includes data pre-processing, tractography, generation of structural connectomes and calculation of graph-based metrics. The results were evaluated both with statistical analysis of variability and consistency among sites with the traveling brains range. In addition, inter-site reproducibility was assessed in terms of intra-class correlation variability.

RESULTS: The results show an inter-center and inter-subject variability of <10%, except for “clustering coefficient” (variability of 30%). Statistical analysis identifies significant differences among sites, as expected given the wide range of scanners’ hardware.

CONCLUSIONS: The results show low variability of connectivity topological metrics across sites running a harmonised protocol.

PMID:37331082 | DOI:10.1016/j.ejmp.2023.102610

J Plast Reconstr Aesthet Surg. 2023 May 28;84:176-181. doi: 10.1016/j.bjps.2023.05.050. Online ahead of print.

ABSTRACT

BACKGROUND: Gender-affirming mastectomies are a growing necessity for transgender and gender-diverse patients. The preoperative evaluation and surgical outcome must be tailored to the individual, taking into consideration previous medical history, medications, hormonal therapy, patient anatomy, and expectations. Although non-binary patients constitute a significant portion of patients referring for gender-affirming mastectomies, current literature rarely acknowledges them as a separate patient category from trans-masculine patients.

METHODS: Retrospective cohort, demonstrating the single-surgeon experience with gender-affirming mastectomies over the course of 2 decades.

RESULTS: A total of 208 patients were included in this cohort, patients identifying as “non-binary” in gender accounted for 30.8% of the cohort. Non-binary patients were found to be younger (P value<0.001) at the time of surgery, at the time of HRT initiation (P value<0.001), at the first feeling of gender dysphoria, coming out to society, and use of non-female pronouns (P value = 0.04,<0.001 and<0.001, accordingly). In the non-binary patient group, a shorter period of time passed from the first feeling of gender dysphoria to initiation of HRT and surgery (P value<0.001 and<0.001, accordingly). However, the average time from HRT initiation to surgery and from the first use of non-female pronouns to HRT initiation or surgery did not statistically differ (P value= 0.34, 0.06, and 0.08, accordingly).

CONCLUSION: Non-binary patients demonstrate a significantly different timeline from trans-masculine patients in terms of gender development. In order to accommodate their needs, caregivers must take the information into consideration and develop appropriate guidelines and courses of action.

PMID:37331039 | DOI:10.1016/j.bjps.2023.05.050

Int J Paediatr Dent. 2023 Jun 18. doi: 10.1111/ipd.13096. Online ahead of print.

ABSTRACT

BACKGROUND: Early childhood caries (ECC) is one of the most common dental problems, which often require dental rehabilitation with general anesthesia (DRGA).

AIM: To assess the short- and long-term effects of DRGA on children and their families’ oral health-related quality of life (OHRQoL) in preschool children, the incidence of complications on the first day, and the factors affecting them and parental satisfaction.

DESIGN: A total of 150 children treated for ECC under DRGA were included in the study. OHRQoL was assessed on the day of DRGA, 4 weeks, and 1 year after treatment using the Early Childhood Oral Health Impact Scale (ECOHIS). The incidence of complications and parental satisfaction with DRGA were evaluated. The data were analyzed for statistical significance (p<0.05).

RESULTS: In total, 134 patients were re-evaluated at the end of the 4th week and 120 at the end of the 1st year. The average ECOHIS scores before and after DRGA (4 weeks and 1 year) were 18.1±8.5, 3.1±3.9, 5.9±6.2, respectively. After DRGA, 29.2% of the children reported at least one complication. 91% of the parents reported that they were satisfied with DRGA.

CONCLUSION: DRGA has a positive effect on the OHRQoL of Turkish preschool children with ECC and is highly evaluated by their parents.

PMID:37331006 | DOI:10.1111/ipd.13096

J Neurol. 2023 Jun 18. doi: 10.1007/s00415-023-11824-w. Online ahead of print.

ABSTRACT

BACKGROUND: New diagnostic criteria of Progressive Supranuclear Palsy (PSP) have highlighted the interest of Eye Movement Records (EMR) at the early stage of the disease.

OBJECTIVES: To investigate the metabolic brain correlates of ocular motor dysfunction using [18F] Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in early PSP.

METHODS: Retrospective observational descriptive study on longitudinal data with patients who underwent EMR and FDG-PET at the stage of suggestive and possible PSP according to Movement Disorders Society criteria. Longitudinal follow-up enables to confirm diagnosis of probable PSP. Using the Statistical Parametric Mapping software, we performed whole-brain voxel-based correlations between oculomotor variables and FDG-PET metabolism.

RESULTS: Thirty-seven patients with early PSP who fulfilled criteria of probable PSP during the follow-up were included. Decrease in the gain of vertical saccades correlated with reduced metabolism in Superior Colliculi (SC). We also found a positive correlation between mean velocity of horizontal saccades and SC metabolism as well as dorsal nuclei in the pons. Finally, increase in horizontal saccades latencies correlated with decrease of posterior parietal metabolism.

CONCLUSIONS: These findings suggest the early involvement of SC in saccadic dysfunction in the course of PSP.

PMID:37330976 | DOI:10.1007/s00415-023-11824-w

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:26018. doi: 10.4317/medoral.26018. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to investigate predisposing factors for the head and neck infections (HNIs), regarding to the demographic data, anatomical spaces, microbiology and antibiotic sensitivity for affected patients.

MATERIAL AND METHODS: A 13-year of retrospective study evaluating 470 patients with HNIs, treated as inpatient management in the Department of Oral and Maxillofacial Surgery of KyungHee University school of Dentistry, Seoul, Korea, from January 2009 to February 2022. Statistical analysis of demographic, time-related, anatomic, microbiologic, and treatment variables were investigated for each patient.

RESULTS: The frequency of HNIs was significantly higher in 50’s in males, followed by 70’s in females. High Severity score (SS) were significantly associated with increased LOH (Length of hospital stay) and LOM (Length of medication), while LOH showed more intensive relationship compared with LOM. The most frequently involved space in abscess was submandibular space, though incidence and severity of HNIs shows declining tendency throughout 13-year research. Streptococcus viridans was the most predominant species isolated from pus culture growth, and a combination of ampicillin and sulbactam was the 1st choice of antibiotics intravenously. According to the comparison analysis between recommended antibiotics from resistance testing result and clinically administered antibiotics, final coincidence rate was estimated about 55%.

CONCLUSIONS: Due to HNIs being multifactorial, predicting progression and management of HNIs is still a challenge for oral and maxillofacial surgeons. The present study showed several predisposing factors of SHNIs and their correlations, which could contribute to earlier diagnosis and more effective treatment planning for clinicians, thereby leading to the improvement of prognosis for patients, ultimately.

PMID:37330958 | DOI:10.4317/medoral.26018

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:26011. doi: 10.4317/medoral.26011. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of our study is to evaluate the usability of the Free Gingival Graft (FGG) procedure, which is included in YouTube videos, in both patient information and student education.

MATERIAL AND METHODS: A search was performed on YouTube on December 1, in 2022, using the search term ”Free Gingival Graft”. First 150 videos were pre-evaluated, and 67 videos were included in the study. The length of the videos, the number of views, the number of likes, the presence of animation and the number of months after uploading were evaluated. The quality of the videos was evaluated and analyzed with The Global Quality Score (GQS), Usefulness Score (US) and The Journal of American Medical Association (JAMA) scores.

RESULTS: A positive correlation was found between viewer interaction, video duration and quality scores. The median values of the quality scores were 2 for the GQS, 2 for the JAMA score and 1 for the Usefulness score. The level of quality scores was found to be insufficient (poor quality). There is a high level, positive and statistically significant correlation between the GQS and the Usefulness score (r=0.858 and p<0.001).

CONCLUSIONS: YouTube videos containing the FGG procedure were found to be insufficient for both student education and patient information purposes.

PMID:37330957 | DOI:10.4317/medoral.26011

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:25950. doi: 10.4317/medoral.25950. Online ahead of print.

ABSTRACT

BACKGROUND: The use of graphic novels is a trending topic in health communication as a new form of visual storytelling which explores narratives of health care, cancer, healing, and disability. The objective of the present study was to evaluate – for the first time in the literature – the effect of graphic novels in reducing the anxiety of patients waiting for an incisional biopsy in an oral oncology setting.

MATERIAL AND METHODS: This open-label randomized clinical trial comprised 50 patients with a clinical suspicion of oral potentially malignant disorders. Twenty-five patients were randomly allocated to the test group, and a colourful graphic novel was provided. Subsequently, the Beck Depression Inventory and the Depression Anxiety Stress Scales-21 were administered to all 50 recruited patients, after which a biopsy was performed on each patient.

RESULTS: No statistically significant difference was observed between the test and control groups for the variables regarding the demographic data (p>0.2). There was a significant difference after the introduction of the graphic novel, regardless of which questionnaire was used. The graphic novel demonstrated an improvement in the ability of the test group to tolerate anxiety while waiting for an oral biopsy in both psychological tests (p<0.05).

CONCLUSIONS: In light of these initial positive results, the authors of this study would like to suggest the use of graphic novels in oral oncology, dentistry, and medicine with the aim of reducing patient anxiety.

PMID:37330956 | DOI:10.4317/medoral.25950