Tag: nevin manimala

Clin Oral Investig. 2023 Apr 10. doi: 10.1007/s00784-023-04988-2. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the relationship between pain inflammation due to dental caries and growth parameters, sleep disturbances, and oral health-related quality of life (OHRQoL) in preschool children before/after dental treatment and compare the results with the control group.

MATERIALS AND METHODS: Study (pain inflammation due to caries) and control groups were included in this prospective clinical trial. The Child Sleep Habits Questionnaire (CSHQ) assessing sleep disturbances and the Early Childhood Oral Health Impact Scale (ECOHIS) assessing OHRQoL were applied in the corresponding time intervals to the study and control groups, respectively: baseline (T0_study), 7 days after treatment (T1_study), and following 6 months (T2_study); baseline (T0_control), and the following 6 months (T2_control). Biochemical growth parameters (insulin-like growth factor-1 and insulin-like growth factor binding protein-3) and anthropometric measurements (standard deviation score of height, weight, and body mass index) were obtained at T0_study, T2_study, and T0_control. Mann-Whitney U and the Student t-tests were used for statistical analyses. The significance level was set at p < 0.05.

RESULTS: Data on 45 children (mean age: 55.6 ± 10.37 months) were analyzed. T2_study was statistically higher than T0_study for the anthropometric measurements and biochemical growth parameters (p < 0.05). T0_study was statistically higher than T0_control for biochemical growth parameters (p < 0.05). CSHQ and ECOHIS scores were found statistically significant at T0_study than T0_control (p < 0.05). Statistical scores of CSHQ and ECOHIS in T2_study were significantly reduced compared to T0_study (p < 0.05).

CONCLUSION: Children’s growth parameters, sleep disturbances, and OHRQoL improved after the elimination of pain and inflammation.

CLINICAL RELEVANCE: This study’s novelty is the observation of drastically increased growth parameters and reduced sleep disturbances following dental treatment.

PMID:37036512 | DOI:10.1007/s00784-023-04988-2

Graefes Arch Clin Exp Ophthalmol. 2023 Apr 10. doi: 10.1007/s00417-023-06042-z. Online ahead of print.

ABSTRACT

PURPOSE: This study is to assess the possible correlation between findings on fundus autofluorescence (FAF) and fluorescein angiography (FA) in patients with chronic central serous chorioretinopathy (cCSC).

METHODS: This multicentre retrospective cohort study included 71 cCSC patients (92 eyes) with at least 6 months of follow-up, who had a FAF-FA imaging discrepancy larger than 0.5 optic disc diameters in size in the corresponding areas of hyperfluorescent abnormalities. A comparison was performed between progression in size of areas of hyperautofluorescent retinal pigment epithelium (RPE) abnormalities on FAF (HF-FAF) and the hyperfluorescent areas on FA (HF-FA) at first visit and last visit. The possible correlations were estimated between FAF-FA discrepancy and disease characteristics.

RESULTS: The median area of HF-FAF at first visit was 7.48 mm² (1.41-27.9). The median area of HF-FA at first visit and last visit was 2.40 mm² (0.02-17.27) and 5.22 mm² (0.53-25.62), respectively. FAF-FA discrepancy was associated with follow-up duration and the area of HF-FAF at first visit. A mathematical algorithm for grading FAF-FA discrepancy in time was suggested, which predicted the enlargement of hyperfluorescent RPE abnormalities on FA in 82.6% of cases.

CONCLUSION: There is a statistically significant relationship between the areas of HF-FAF and HF-FA in cCSC patients with FAF-FA imaging discrepancy at first presentation. Long-term changes in RPE alterations in cCSC on FA can be predicted based on baseline HF-FAF and follow-up duration.

PMID:37036511 | DOI:10.1007/s00417-023-06042-z

Acta Diabetol. 2023 Apr 10. doi: 10.1007/s00592-023-02084-1. Online ahead of print.

ABSTRACT

AIMS: This study examined whether the Chronic Care Model can be successfully applied to improve health outcome measures for uninsured, undocumented immigrants with diabetes at a free, non-federally funded community clinic.

METHODS: Data were collected from 128 uninsured, undocumented immigrants enrolled in Programa de diabetes, a comprehensive diabetes program at People’s Health Clinic based on the six core elements of the Chronic Care Model. All study participants self-identified by the Hispanic ethnicity. A longitudinal study design was used to compare baseline diabetic health measures with outcome data after patient program participation over a 12-month enrollment period. Linear mixed effect model was used to determine the patient specific change in HbA1C across time, controlling for gender, age, food insecurity, income level, diabetes type, and literacy. In addition, McNemar tests were conducted to compare the coverage of eye exams and statin use before and after program enrollment.

RESULTS: After program enrollment, individual specific change in HbA1C was expected to be – 0.201 [95% CI 0.244, – 0.158] % per month after controlling for baseline covariates. There were statistically significant improvements in both eye exam coverage (p < 0.01) and statin use (p < 0.01).

CONCLUSIONS: The Chronic Care Model can be successfully applied to improve health outcome measures at a free, non-federally funded community clinic among uninsured, undocumented immigrants, who identify by the Hispanic ethnicity and have the diagnosis of diabetes. Barriers to care including food insecurity, federal poverty level and illiteracy do not preclude glycemic control.

PMID:37036509 | DOI:10.1007/s00592-023-02084-1

Curr Microbiol. 2023 Apr 10;80(5):177. doi: 10.1007/s00284-023-03292-2.

ABSTRACT

Photosynthetic microbial fuel cell (PMFC) is an environmentally friendly sustainable technique for simultaneous wastewater treatment and power recovery. PMFC utilizes the microalgae to generate oxygen by photosynthesis process in the biocathode. Light sources and intensities have direct effect on chlorophyll pigment formation, photosynthesis processes and microalgae growth. In this study, Chlorella vulgaris was utilized as biocathode in PMFC fed with actual slaughterhouse wastewater. The biocathode was illuminated with florescent light as well as yellow, red and blue LED lights with light intensities of 67.46, 47.03, 26.18 and 4.70 µmol/m.s, respectively. Power output and microalgae growth were considered in evaluating the PMFC performance. Results demonstrated that the highest power output was 217.04 mW/m² generated under florescent light compared to 28.41, 171.08, and 21.65 mW/m² observed under yellow, red and blue LEDs, respectively. Additionally, statistical analysis was performed using fifth-degree polynomial model which fitted well the experimental data with a determination coefficient (R²) > 0.97. The results reflected a high confidence level in depicting the growth mechanism of Chlorella vulgaris under lighting sources with different light colors and intensities.

PMID:37036508 | DOI:10.1007/s00284-023-03292-2

Arch Orthop Trauma Surg. 2023 Apr 10. doi: 10.1007/s00402-023-04855-5. Online ahead of print.

ABSTRACT

BACKGROUND: Liner malseating is well described in ceramic-on-ceramic total hip arthroplasties (THAs). However, limited information is known on this complication among dual-mobility articulations. As such, this systematic review analyzed liner malseating in dual-mobility THAs concerning prevalence, clinical implications, and associated risk factors.

METHODS: A PRISMA criteria-based systematic review was performed, and PubMed, Web of Science, MEDLINE, and Cochrane used as data bases. All original studies from 1980 to 2022 were considered eligible for inclusion, and Methodological Index for Nonrandomized Studies (MINORS) used for quality assessment.

RESULTS: In total, five retrospective cohort studies with 2330 patients (2673 dual-mobility THAs) were included. Mean age was 66.9 years, mean BMI was 29.8 kg/m2, and 35% of patients were female. Rates of malseating ranged from 0.15% to 5.8%, with a total of 53 malseated liners identified throughout all studies (1.98%). Based on THA manufacturer, malseating occurred in 48 Stryker (1.96%) and 5 Biomet Zimmer (2.14%) THAs. Mean clinical follow-up was 2.2 years (mean range, 1.3 to 6.4 years). Except one patient reporting of pain at 2 years, no revision or negative clinical implication was noted in any of the malseated liners, including normal ranged metal ions measured in four cases. A smaller acetabular component size was identified as a statistically significant risk factor for malseating in one study. Mean MINORS score was 9.8.

CONCLUSIONS: Liner malseating is a rare finding in patients undergoing THAs with dual-mobility articulations. While prelim results demonstrate no negative clinical consequences to date, existing studies are limited, refer to short-term outcomes only, and do not prospectively follow-up affected patients.

LEVEL OF EVIDENCE: IV.

PMID:37036501 | DOI:10.1007/s00402-023-04855-5

Int Orthop. 2023 Apr 10. doi: 10.1007/s00264-023-05788-9. Online ahead of print.

ABSTRACT

PURPOSE: Several reports have identified prognostic factors for hip osteonecrosis treated with cell therapy, but no study investigated the accuracy of artificial intelligence method such as machine learning and artificial neural network (ANN) to predict the efficiency of the treatment. We determined the benefit of cell therapy compared with core decompression or natural evolution, and developed machine-learning algorithms for predicting ten year collapse-free survival in hip osteonecrosis treated with cell therapy. Using the best algorithm, we propose a calculator for “prognosis hip osteonecrosis cell therapy (PHOCT)” accessible for clinical use.

METHODS: A total of 3145 patients with 5261 osteonecroses without collapses were included in this study, comprising 1321 (42%) men and 1824 (58%) women, with a median age of 34 (12-62) years. Cell therapy was the treatment for 3021 hips, core decompression alone for 1374 hips, while absence of treatment was the control group of 764 hips. First, logistic regression and binary logistic regression analysis were performed to compare results of the three groups at ten years. Then an artificial neural network model was developed for ten year collapse-free survival after cell therapy. The models’ performances were compared. The algorithms were assessed by calibration, and performance, and with c-statistic as measure of discrimination. It ranges from 0.5 to 1.0, with 1.0 being perfect discrimination and 0.5 poor (no better than chance at making a prediction).

RESULTS: Among the 3021 hips with cell therapy, 1964 hips (65%) were collapse-free survival at ten years, versus 453 (33%) among those 1374 treated with core decompression alone, and versus 115 (15%) among 764 hips with natural evolution. We analyzed factors influencing the prediction of collapse-free period with classical statistics and artificial intelligence among hips with cell therapy. After selecting variables, a machine learning algorithm created a prognosis osteonecrosis cell therapy calculator (POCT). This calculator proved to have good accuracy on validation in these series of 3021 hip osteonecroses treated with cell therapy. The algorithm had a c-statistic of 0.871 suggesting good-to-excellent discrimination when all the osteonecroses were mixed. The c-statistics were calculated separately for subpopulations of categorical osteonecroses. It retained good accuracy, but underestimated ten year survival in some subgroups, suggesting that specific calculators could be useful for some subgroups. This study highlights the importance of multimodal evaluation of patient parameters and shows the degree to which the outcome is modified by some decisions that are within a surgeon’s control, as the number of cells to aspirate, the choice of injecting in both the osteonecrosis and the healthy bone, the choice between unilateral or bilateral injection, and the possibility to do a repeat injection.

CONCLUSION: Many disease conditions and the heterogeneities of patients are causes of variation of outcome after cell therapy for osteonecrosis. Predicting therapeutic effectiveness with a calculator allows a good discrimination to target patients who are most likely to benefit from this intervention.

PMID:37036496 | DOI:10.1007/s00264-023-05788-9

Eur J Nucl Med Mol Imaging. 2023 Apr 10. doi: 10.1007/s00259-023-06191-7. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the diagnostic accuracy of the hybrid tracer indocyanine green (ICG)-Technetium-99 m(^99mTc)-nanocolloid compared to sequential tracers of ^99mTc-nanocolloid and free-ICG in detecting tumor-positive lymph nodes (LN) during primary surgery in prostate cancer (PCa) patients.

INTRODUCTION: Image-guided surgery strategies can help visualize individual lymphatic drainage patterns and sentinel lymph nodes (SLNs) in PCa patients. For lymphatic mapping radioactive, fluorescent and hybrid tracers are being clinically exploited. In this prospective randomized phase II trial, we made a head-to-head comparison between ICG-^99mTc-nanocolloid (hybrid group) and ^99mTc-nanocolloid and subsequent free-ICG injection (sequential group).

METHODS: PCa patients with a >5% risk of lymphatic involvement according to the 2012 Briganti nomogram and planned for prostatectomy were included and randomized (1:1) between ultrasound-guided intraprostatic tracer administration of ICG-^99mTc-nanocolloid (n = 69) or ^99mTc-nanocolloid (n = 69) 5 h before surgery. Preoperative lymphoscintigraphy and SPECT/CT were performed to define the locations of the SLNs. Additionally, all participants in the sequential group received an injection of free-ICG at time of surgery. Subsequently, all (S)LNs were dissected using fluorescence guidance followed by an extended pelvic lymph node dissection (ePLND). The primary outcome was the total number of surgically removed (S)LNs and tumor-positive (S)LNs.

RESULTS: The total number of surgically removed (S)LN packages was 701 and 733 in the hybrid and sequential groups, respectively (p = 0.727). The total number of fluorescent LNs retrieved was 310 and 665 nodes in the hybrid and sequential groups, respectively (p < 0.001). However, no statistically significant difference was observed in the corresponding number of tumor-positive nodes among the groups (44 vs. 33; p = 0.470). Consequently, the rate of tumor-positive fluorescent LNs was higher in the hybrid group (7.4%) compared to the sequential group (2.6%; p = 0.002), indicating an enhanced positive predictive value for the hybrid approach. There was no difference in complications within 90 days after surgery (p = 0.78).

CONCLUSIONS: The hybrid tracer ICG-^99mTc-nanocolloid improved the positive predictive value for tumor-bearing LNs while minimizing the number of fluorescent nodes compared to the sequential tracer approach. Consequently, the hybrid tracer ICG-^99mTc-nanocolloid enables the most reliable and minimal invasive method for LN staging in PCa patients.

PMID:37036490 | DOI:10.1007/s00259-023-06191-7

Abdom Radiol (NY). 2023 Apr 10. doi: 10.1007/s00261-023-03894-1. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of various prostate biopsy protocols with reduced cores on the detection of clinically significant prostate cancer (csPCa) in individuals with MRI-visible lesions (Prostate Imaging Reporting and Data System ≥ 3).

METHODS: A total of 464 patients with MRI-visible lesions were recruited. All patients underwent two or more targeted biopsies (TB) and systematic biopsies (SB). Several hypothetical biopsy schemes were set-up: TB alone, TB+ipsilateral SB, TB+contralateral SB, TB+SB of the targeted sector (TB+t-SB), and TB+SB of the non-targeted sector (TB+n-SB). A subgroup analysis of patients with multiple MRI-visible lesions was performed. The standard of reference was defined as TB+SB. McNemar test was used to compare csPCa detection rates between various sampling schemes.

RESULTS: The detection rates for prostate cancer and csPCa were 72.8% (338 of 464) and 62.1% (288 of 464), respectively. There were 8.0%, 0.3%, 6.3%, 1.0%, and 4.5% cases in which TB alone, TB+ipsilateral SB, TB+contralateral SB, TB+t-SB, and TB+n-SB would have missed csPCa, respectively. All hypothetical schemes, with the exception of TB+contralateral SB (p = 0.063), significantly outperformed TB alone in terms of csPCa detection (p < 0.05). As for the multi-focus cohort, which included 48 cases, none of the non-index lesions had a higher Gleason grade than the index lesions within the same patients.

CONCLUSION: TB+ipsilateral SB might be the optimal biopsy scheme for detecting csPCa. As for the multi-focus cohort, the biopsy of the non-index lesions provided limited pathological information.

PMID:37036488 | DOI:10.1007/s00261-023-03894-1

Eur Radiol. 2023 Apr 10. doi: 10.1007/s00330-023-09553-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the correlation between histogram parameters derived from synthetic magnetic resonance imaging (SyMRI) and prognostically relevant factors in nasopharyngeal carcinoma (NPC).

METHODS: Fifty-nine consecutive NPC patients were prospectively enrolled. Quantitative parameters (T1, T2, and proton density (PD)) were obtained by outlining the three-dimensional volume of interest (VOI) of all lesions. Then, histogram analysis of these quantitative parameters was performed and the correlations with prognostically relevant factors were assessed. By choosing appropriate cutoff, we divided the sample into two groups. Independent-samples t test/Mann-Whitney U test was used and ROC curve analysis was further processed.

RESULTS: Histogram parameters of the T1, T2, and PD maps were positively correlated with the Ki-67 expression levels, and PD_mean was the most representative parameter (AUC: 0.861). The PD map exhibited good performance in differentiating epidermal growth factor receptor (EGFR) expression levels (AUC: 0.706~0.732) and histological type (AUC: 0.650~0.660). T2_minimum was highest correlated with Epstein-Barr virus (EBV) DNA levels (r = – 0.419), and PD_75th percentile exhibited the highest performance in distinguishing positive and negative EBV DNA groups (AUC: 0.721). T1_minimum was statistically correlated with EA-IgA expression (r = – 0.313). Additionally, several histogram parameters were negatively correlated with tumor stage (T stage: r = – 0.259 ~ – 0.301; N stage: r = – 0.348 ~ – 0.456; clinical stage: r = – 0.419).

CONCLUSIONS: Histogram parameters of SyMRI could reflect tissue intrinsic characteristics and showed potential value in assessing the Ki-67 and EGFR expression levels, histological type, EBV DNA level, EA-IgA, and tumor stage.

KEY POINTS: • SyMRI combined with histogram analysis may help clinicians to assess different prognostic factor statuses in nasopharyngeal carcinoma. • The PD map exhibited good discriminating performance in the Ki-67 and EGFR expression levels. • Histogram parameters of SyMRI were negatively correlated with EBV-related blood biomarkers and TNM stage.

PMID:37036478 | DOI:10.1007/s00330-023-09553-9

Biom J. 2023 Apr 10:e2200016. doi: 10.1002/bimj.202200016. Online ahead of print.

ABSTRACT

We propose a hidden Markov model for multivariate continuous longitudinal responses with covariates that accounts for three different types of missing pattern: (I) partially missing outcomes at a given time occasion, (II) completely missing outcomes at a given time occasion (intermittent pattern), and (III) dropout before the end of the period of observation (monotone pattern). The missing-at-random (MAR) assumption is formulated to deal with the first two types of missingness, while to account for the informative dropout, we rely on an extra absorbing state. Estimation of the model parameters is based on the maximum likelihood method that is implemented by an expectation-maximization (EM) algorithm relying on suitable recursions. The proposal is illustrated by a Monte Carlo simulation study and an application based on historical data on primary biliary cholangitis.

PMID:37035989 | DOI:10.1002/bimj.202200016