Tag: nevin manimala

J Robot Surg. 2023 Jun 13. doi: 10.1007/s11701-023-01622-x. Online ahead of print.

ABSTRACT

Active surveillance (AS), radical prostatectomy (RP), and radical radiotherapy (RT) are the three options for localized prostate cancer. Only a few studies have been conducted in developing countries or in centers in their initial learning curve that predict the outcomes of RARP. Therefore, this study aimed to present data from a novice center; how we started and progressed, and to compare our results with the rest of the world. This is a retrospective analysis to study the outcomes following robot-assisted radical prostatectomy and to identify the predictors of quadrifecta outcomes, i.e., the patients who were continent, did not have complications, were biochemical recurrence free with at least 1 year of follow-up and had negative surgical margins. In our data, we excluded the erectile function as one of the parameters as the majority of our patients were not sexually active or did not want to discuss this parameter. Seventy-two patients were included in this study, and 50 (69.4%) of these achieved the quadrifecta outcomes. Of all the factors, studied, seven factors were statistically significantly different between Group I (quadrifecta achieved) and Group II (quadrifecta not achieved), namely, BMI, co-morbidities like CAD, COPD, ASA grade, pre-op D’Amico risk stratification groups, clinical staging, positive lymph-node status, and hospital stay. With this study, we reported outcomes of RARP in a newly established robotic center and the results were fairly comparable with the well-developed center in India and abroad, emphasizing the short learning curve, and so, the requirement of establishing more robotic surgery centers in developing as well as developed countries.

PMID:37310526 | DOI:10.1007/s11701-023-01622-x

Clin Oral Implants Res. 2023 Jun 13. doi: 10.1111/clr.14114. Online ahead of print.

ABSTRACT

AIM: To compare, at different levels from the alveolar crest, the radiographic outcomes of equine-derived collagenated xenogeneic bone blocks (CXBB) and autogenous bone blocks (ABB) used for lateral alveolar ridge augmentation.

MATERIALS AND METHODS: Sixty-four patients with tooth gaps in atrophic alveolar ridges with ≤4 mm were randomly assigned to lateral augmentation using CXBB or ABB. The lateral bone thickness (LBT) was measured 2, 4, 6, 8, and 10 mm below the alveolar crest using CBCT scans obtained before augmentation surgery and at 30 weeks, prior to implant placement. Statistical analysis was performed using Shapiro-Wilk, Fisher’s exact, Mann-Whitney, and Wilcoxon signed-rank tests.

RESULTS: Both CXBB and ABB resulted in significant total and buccal LBT gains at 2, 4, 6, 8, and 10 mm. LBT gains were similar between CXBB- and ABB-augmented sites, except for greater buccal LBT gains at 8 mm at CXBB-augmented sites. While ABB-augmented sites gained vertical bone height, CXBB-treated sites suffered vertical bone loss (CXBB: -0.16 mm; ABB: 0.38 mm, p < .0009).

CONCLUSIONS: CXBB and ABB were both associated with significant and similar LBT gains at 30 weeks.

PMID:37309738 | DOI:10.1111/clr.14114

Clin Implant Dent Relat Res. 2023 Jun 13. doi: 10.1111/cid.13233. Online ahead of print.

ABSTRACT

BACKGROUND: The long-term clinical outcome of mini dental implants (MDIs) to support an overdenture is underreported especially in severely atrophic maxillae and when installed flaplessly.

PURPOSE: The current report is a 5-years follow-up of the previously published 2- and 3-years clinical outcome of MDIs supporting a maxillary overdenture in narrow alveolar ridges. MDI survival, marginal bone level, peri-implant health, technical complications, and oral health related quality of life (OHIP) and respective changes over time are reported.

MATERIALS AND METHODS: Subjects aged 50 years or older, in need of improvement of maxillary denture retention, were included. The MDIs were 2.4 mm diameter one-piece tapered implants, Class 4 pure Titanium, and lengths 10 or 11.5 mm. Under local anesthesia, 5-6 MDIs were placed in atrophic maxillae with a free-handed flapless approach. One week postoperative the denture was adapted with a retentive soft reliner. The final prosthetic connection was established after 6 months with a metal-reinforced horse-shoe denture. Clinical outcome after 5 years was assessed with probing pocket depts (PPD), bleeding on probing (BoP), and additional cone beam computed tomography (CBCT) MDI bone level measurements were performed. Oral Health-Related Quality of Life (OHRQoL) investigated with OHIP-14 was assessed preoperative, during provisional loading, and after final prosthetic connection up to 5 years.

RESULTS: Initially, 31 patients (14 females and 17 males) with mean age 62.30 underwent treatment. In the provisional loading interval, 16 patients encountered 32/185 MDIs failures, resulting in a failure of 17.3%; 170 MDIs were functionally loaded in 29 patients. Additionally, 14 implants were lost in three patients, all of whom had had already previous failures. Reimplantation of 17 MDIs were performed during the provisional loading and 2 MDI after functional loading. After 5 years, the absolute implant failure rate was 46/204 (22.5%), corresponding to a cumulative failure rate of 23.2%. Prosthetic failure was observed in four patients due to implant loss and in two patients related to excessive one-piece implant ball attachment wear, making the 5-years prosthetic success 80.0%. The mean PPD and absence/presence of BoP for 149 implants at 5 years was 4.3 and 0.2 mm, respectively. Average mesial-distal-vestibular-palatal bone loss in the interval 2-5 years was 0.08 mm. No statistically significant difference in marginal MDI bone loss between male or female (p = 0.835), smoking and nonsmoking (p = 0.666) was observed. The five-years total measured CBCT interdental bone level (mesial and distal) correlates with the 5-years PPD (Pearson 0.434; p = 0.01). After 5 years, OHRQoL with the treatment procedure was assessed in 27/31 participants. Decreasing mean total OHIP-14 scores with improved OHRQoL, was observed in 27/31 participants, with values of 21.3 at baseline to 15.6 at the time of provisional loading which significantly (p = 0.006) decrease to 7.3 at the final prosthetic connection. The next 3-5 years further decrease was observed with 6.5 and 4.96, respectively.

CONCLUSIONS: Maxillary MDIs for overdentures are an accessible and acceptable treatment option. Although after 5 years between one fifth and one fourth of the MDIs were lost, prosthetic success remains 80.0% and high OHRQoL could be achieved.

PMID:37309711 | DOI:10.1111/cid.13233

Clin Implant Dent Relat Res. 2023 Jun 13. doi: 10.1111/cid.13234. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the present study was to evaluate the effect of obesity on the osseointegration of implants with hydrophobic and hydrophilic surfaces.

MATERIALS AND METHODS: Sixty-four male rats were distributed among four experimental groups: H-HB (Healthy/Hydrophobic): healthy animals with hydrophobic implants; H-HL (Healthy/Hydrophilic): healthy animals with hydrophilic implants; O-HB (Obese/Hydrophobic): animals with induced obesity and hydrophobic implants; O-HL (Obese/Hydrophilic): animals with induced obesity and hydrophilic implants. One hundred and twenty-eight implants were installed in the tibiae of the animals bilaterally (64 on the left tibiae and 64 on the right one) after 75 days of a specific diet (standard or high-fat diet) and euthanasia was performed in the experimental periods of 15 and 45 days after implant placement. Bone formation was assessed by biomechanical analysis (on the left tibiae of each animal), and microtomographic and histomorphometric analyses (on the right tibiae of each animal). Statistical analysis was performed using the Shapiro-Wilk test for normality and ANOVA followed by Tukey test to observe whether there was a significant difference between groups (p < 0.05); the t-test was used to compare the animals’ body weight.

RESULTS: The biomechanical analysis showed an increase in the removal torque value of animals after 45 days in comparison to after 15 days, with the exception of O-HB groups. The microtomographic analysis demonstrated no significant differences in the mineralized bone tissue volume between the groups. In the histomorphometric analysis, the H-HL/45 day group/period demonstrated higher bone-implant contact, in comparison to H-HL/15 days and the O-HL/45 day group/period showed an increase in bone area between the implant threads, in comparison to O-HL/15 days.

CONCLUSION: In conclusion, obesity does not interfere with the osseointegration of hydrophobic and hydrophilic implants.

PMID:37309706 | DOI:10.1111/cid.13234

Faraday Discuss. 2023 Jun 13. doi: 10.1039/d3fd00008g. Online ahead of print.

ABSTRACT

In order to obtain a good understanding of astrochemistry, it is crucial to better understand the key parameters that govern grain-surface chemistry. For many chemical networks, these crucial parameters are the binding energies of the species. However, there exists much disagreement regarding these values in the literature. In this work, a Bayesian inference approach is taken to estimate these values. It is found that this is difficult to do in the absence of enough data. The Massive Optimised Parameter Estimation and Data (MOPED) compression algorithm is then used to help determine which species should be prioritised for future detections in order to better constrain the values of binding energies. Finally, an interpretable machine learning approach is taken in order to better understand the non-linear relationship between binding energies and the final abundances of specific species of interest.

PMID:37309692 | DOI:10.1039/d3fd00008g

JMIR Public Health Surveill. 2023 Jun 13. doi: 10.2196/45212. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer and cause of cancer death in women. Although survival rates have improved, unmet psychosocial needs remain challenging because the quality of life (QoL) and QoL-related factors change over time. In addition, traditional statistical models have limitations in identifying factors associated with QoL over time, particularly concerning the physical, psychological, economic, spiritual, and social dimensions.

OBJECTIVE: This study aimed to identify patient-centered factors associated with QoL among breast cancer patients using a machine learning algorithm to analyze data collected along different survivorship trajectories.

METHODS: The study used two datasets: the first data set was the cross-sectional survey data from the Breast cancer Information Grand round for Survivorship (BIG-S) study, which recruited consecutive breast cancer survivors who visited the outpatient breast cancer clinic at the Samsung Medical Center in Seoul, Korea, between 2018 and 2019. The second data set was the longitudinal cohort data from the Beauty Education for diStressed breasT cancer (BEST) cohort study, which was conducted at two university-based cancer hospitals in Seoul, Korea between 2011 and 2016. QoL was measured using EORTC QLQ-C30 questionnaire. Feature importance was interpreted using Shapley Additive Explanations (SHAP). The final model was selected based on the highest mean area under the receiver operating characteristic curve (AUC). The analyses were performed using the Python 3.7, scikit-learn package, and TensorFlow Keras framework.

RESULTS: The study included 6,265 breast cancer survivors in the training dataset and 432 patients in the validation set. Mean age was 50.6 years and 46.8% had stage 1 cancer. In the training dataset, 48.3% survivors had poor QoL. The study developed machine learning models for QoL prediction based on six algorithms. Performance was good for all survival trajectories: overall (AUC = 0.823), baseline (AUC = 0.835), under 1 year (AUC = 0.860), between 2 and 3 years (AUC = 0.808), between 3 and 4 years (AUC = 0.820), and between 4 and 5 years (AUC = 0.826). Emotional and physical functions were the most important features before surgery and under 1 year after surgery, respectively. Fatigue was the most important feature between 1-4 years. Despite the survival period, hopefulness was the most influential feature on QoL. External validation of the models showed good performance with AUCs between 0.770 and 0.862.

CONCLUSIONS: The study identified important factors associated with QoL among breast cancer survivors across different survival trajectories. Understanding the changing trends of these factors could help to intervene more precisely and timely, and potentially prevent or alleviate QoL-related issues for patients. The good performance of our machine learning models in both training and external validation sets suggests the potential utility of this approach in identifying patient-centered factors and improving survivorship care.

PMID:37309655 | DOI:10.2196/45212

Turk Neurosurg. 2023 Apr 14. doi: 10.5137/1019-5149.JTN.43711-23.2. Online ahead of print.

ABSTRACT

AIM: Treatment of ongoing pain in patients undergoing disc surgery is extremely difficult, and there is no consensus. Our study aimed to evaluate the efficacy of percutaneous pain interventions in these patients.

MATERIAL AND METHODS: We retrospectively analyzed 48 patients with persistent / recurring complaints who underwent lumbar disc surgery (LDS) and were treated with percutaneous interventions. They were grouped into recurrent disc herniations (RDHs) and other discovertebral pathologies (ODVP). Moreover, patients were evaluated as those who received transforaminal injection (TFI) with facet blockage (FB) and who received both caudal injection (CI) and TFI in addition to FB. Patients were evaluated using Oswestry Disability Index (ODI) and visual analog scale (VAS).

RESULTS: Between the recurrent and ODVP groups, preoperative, 1 h postoperative, and 6 mo postoperative ODI (p = 0.867, p = 0.055, p = 0.892) and VAS (p = 0.902, p = 0.136, p = 0.462) scores did not show a statistically significant difference, respectively. Additionally, in the comparison of patients who underwent FB+TFI+CI and only FB+TFI, there was no statistically significant correlation between preoperative and 6 mo postoperative ODI (p = 0.284) and VAS (p = 0.248) scores in both recurrent and ODVP groups, respectively. The success rates at the 3rd and 6th mo of patients with RDH and ODVP were 47.61% (10/21) and 42.85% (9/21) and 70.37% (19/27) and 63.96% (17/27), respectively.

CONCLUSION: There was no statistically significant difference in ODI and VAS scores between recurrent and ODVP groups. The clinical success rate was numerically better in the ODVP group. Thus, we suggest that co-administration of TFI and CI did not significantly contribute to our clinical outcome.

PMID:37309640 | DOI:10.5137/1019-5149.JTN.43711-23.2

Turk Neurosurg. 2023 Jan 18. doi: 10.5137/1019-5149.JTN.42560-22.2. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate Paraoxonase (PON), total antioxidant status (TAS), total oxidant status (TOS), high-density lipoproteins (HDL), CRP, AST, ALT, GGT, ALP levels in patients with head and multiple organ traumas.

MATERIAL AND METHODS: The study included 29 male patients undergoing treatment for head and multiple organ traumas. Blood sample analysis was performed on the first, third, and seventh days after trauma.

RESULTS: The mean age, duration of hospitalization in the intensive care unit, and intubation period of the study sample was 45 years (range: 9 to 81 years), 4.29 days, and 2.94 days, respectively. One patient died, and 13 underwent surgical intervention. Comparison of PON, TAS, TOS, and CRP levels showed statistically significant differences between the first day and the third and seventh days, although no such differences were seen in HDL levels. A moderately positive correlation was observed between CRP/AST, CRP/ALT and between CRP/GGT, while a moderately negative correlation was seen between CRP/ALP.

CONCLUSION: The findings of this study suggest that some oxidative parameters may play a significant role in the prognosis and follow-up of intensive care patients. Moreover, biochemical markers can provide important information about patient response to trauma.

PMID:37309638 | DOI:10.5137/1019-5149.JTN.42560-22.2

Turk Neurosurg. 2022 Nov 30. doi: 10.5137/1019-5149.JTN.40007-22.3. Online ahead of print.

ABSTRACT

AIM: This study aimed to optimize the Spontaneous intracerebral hemorrhage (sICH) early hematoma expansion prediction scoring table based on the clinical data of sICH patients to adopt appropriate clinical treatment plans and improve the prognosis of sICH patients.

MATERIAL AND METHODS: A total of 150 patients with sICH were enrolled, and 44 had early hematoma expansion. According to the selection and exclusion criteria, the study subjects were screened, their NCCT characteristic signs and clinical data were analyzed statistically, and the prediction score table was established. The established prediction score was applied to the follow-up study cohort to conduct a pilot study, and the t-test and ROC curve were used to evaluate its predictive ability.

RESULTS: Statistical analysis found that initial hematoma volume, GCS score, and NCCT special signs were independent risk factors for early hematoma expansion after sICH (P 0.05). Thus, a score table was established. Subjects with ≥10 were divided into high-risk group, 6-8 comprised the medium-risk group, and ≤4 were divided into low-risk group. Among 17 patients with acute sICH, 7 developed early hematoma enlargement. The prediction accuracy was 92.41% in the low-risk group, 98.06% in the medium-risk group, and 84.61% in the high-risk group. It shows the high prediction accuracy of the prediction rating table.

CONCLUSION: This study established a sICH early hematoma expansion prediction score table based on the special signs of NCCT. This table has highly sensitive and accurate.

PMID:37309626 | DOI:10.5137/1019-5149.JTN.40007-22.3

Turk Neurosurg. 2022 Jun 24. doi: 10.5137/1019-5149.JTN.40397-22.3. Online ahead of print.

ABSTRACT

AIM: Medulloblastoma (MB) is a rare tumor whose clinical prognosis remains challenging. Therefore, in this study, we aimed to identify the prognostic factors associated with cancer-specific survival in MB and use them to establish a nomogram model to predict cancer-specific survival.

MATERIAL AND METHODS: In total, 268 patients with MB were included; they were rigorously respectively screened from the Surveillance, Epidemiology, and End Results database from 1988 to 2015 and statistically analyzed in R language. This study focused on cancer-specific death and used the cox regression analysis for variable filtering. The model was calibrated using C-index, area under the curve (AUC), and calibration curve.

RESULTS: As per our findings, it was determined that extension (localized: hazard ratio [HR] = 0.5899, p = 0.00963; further extension: indicator) and treatment modality (radiation after surgery chemotherapy sequence unknown: HR = 0.3646, p = 0.00192; no surgery: indicator) were statistically significant in the prognosis of MB and were finally utilized to construct a nomogram model for predicting the condition. The AUC values were 0.649, 0.629, and 0.64 at 2, 3, and 5 years, respectively.

CONCLUSION: Tumor extension and treatment modality were independent prognostic factors for MB.

PMID:37309623 | DOI:10.5137/1019-5149.JTN.40397-22.3