Tag: nevin manimala

Clin Imaging. 2021 Feb 23;77:17-24. doi: 10.1016/j.clinimag.2021.02.025. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the applicability and accuracy of a new qualitative diffusion-weighted imaging (DWI) assessment method in the characterization of breast tumors compared to quantitative ADC measurement and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI).

MATERIALS AND METHODS: After review board approval, MRIs of 216 consecutive women with final diagnoses (131 malignant, 85 benign) were retrospectively analyzed. Two radiologists independently scored DWI and dynamic contrast-enhanced MRI (DCE-MRI) according to malignancy probability. Qualitative assessments were performed by combined analysis of tumor morphology and diffusion signal. Quantitative data was obtained from apparent diffusion coefficient (ADC) measurements. Lastly, descriptive DWI features were evaluated and recorded. Cohen’s kappa, receiver operating characteristic and multivariate analyzes were applied.

RESULTS: Of malignant tumors, 97% were visible on DWI. Qualitative and quantitative DWI assessments provided comparable sensitivities of 89-94% and 88-92% and specificities of 51-61% and 59-67%, respectively. There was no statistical difference between the accuracies of qualitative and quantitative DWI (p ≥ 0.105). Best diagnostic values were obtained with DCE-MRI (sensitivity, 99-100%; specificity, 69-71%). Inter-reader agreement was moderate (kappa = 0.597) for qualitative DWI and substantial (kappa = 0.689) for DCE-MRI (p < 0.001). Agreement between qualitative DWI and DCE-MRI scores was moderate (kappa = 0.536 and 0.442). Visual diffusion signal, mass margin and shape were the most predictive features of malignancy on multivariate analysis of qualitative assessment.

CONCLUSION: Qualitative characterization of breast tumors on DWI has comparable accuracy to quantitative ADC analysis. This method might be used to make DWI more widely available with eliminating the need to a predetermined ADC threshold in tumor characterization. However, lower accuracy and inter-reader agreement of it compared to DCE-MRI should be considered.

PMID:33639496 | DOI:10.1016/j.clinimag.2021.02.025

Complement Ther Clin Pract. 2021 Feb 17;43:101328. doi: 10.1016/j.ctcp.2021.101328. Online ahead of print.

ABSTRACT

Reiki is a biofield energy therapy that focuses on optimizing the body’s natural healing abilities by balancing the life force energy or qi/chi. Reiki has been shown to reduce stress, pain levels, help with depression/anxiety, increase relaxation, improve fatigue, and quality of life. In this pilot randomized, double-blinded, and placebo-controlled study, the effects of Reiki on heart rate, diastolic and systolic blood pressure, body temperature, and stress levels were explored in an effort to gain objective outcome measures and to understand the underlying physiological mechanisms of how Reiki may be having these therapeutic effects on subjective measures of stress, pain, relaxation, and depression/anxiety. Forty eight (n = 48) subjects were block randomized into three groups (Reiki treatment, sham treatment, and no treatment). The changes in pre- and post-treatment measurements for each outcome measure was analyzed through analysis of variance (ANOVA) post hoc multiple comparison test, which found no statistically significant difference between any of the groups. The p-value for the comparison of Reiki and sham groups for heart rate was 0.053, which is very close to being significant and so, a definitive conclusion can not be made based on this pilot study alone. A second study with a larger sample size is warranted to investigate this finding further and perhaps with additional outcome measures to look at other possible physiological mechanisms that may underlie the therapeutic effects of Reiki.

PMID:33639516 | DOI:10.1016/j.ctcp.2021.101328

Complement Ther Clin Pract. 2021 Feb 19;43:101338. doi: 10.1016/j.ctcp.2021.101338. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective is to examine the effects of progressive muscle relaxation training and music therapy applied to chronic psychiatric patients attending the Community Mental Health Center (CMHC) on their anger level and sleep quality.

METHODS: The sample of the study consisted of 66 chronic psychiatric patients (n = 32 in the control group; n = 34 in the intervention group). Progressive muscle relaxation training with music therapy were implemented in the intervention group as 2 sessions per week for 3 months.

RESULTS: A statistically significant difference was found between the pre-test and post-test mean scores of the intervention group (p ≤ .001). After the intervention, a statistically significant difference was found between the PSQI, anger-in, anger-out, anger-control, and trait anger scale scores of the two groups (p ≤ .001).

CONCLUSION: Relaxation training and music therapy are effective in controlling anger and increasing sleep quality in chronic psychiatric patients.

CLINICAL TRIAL NUMBER: NCT04620122.

PMID:33639518 | DOI:10.1016/j.ctcp.2021.101338

Clin Neurophysiol. 2021 Jan 29;132(4):967-974. doi: 10.1016/j.clinph.2020.11.043. Online ahead of print.

ABSTRACT

OBJECTIVE: Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are disorders of unknown etiology and unclear pathophysiology, with overlapping symptoms of – especially muscular -fatigue and pain. Studies have shown increased muscle fiber conduction velocity (CV) in the non-painful muscles of FM patients. We investigated whether CFS patients also show CV abnormalities.

METHODS: Females with CFS (n = 25), with FM (n = 22), and healthy controls (n = 21) underwent surface electromyography of the biceps brachii, loaded up to 20% of maximum strength, during short static contractions. The mean CV and motor unit potential (MUP) velocities with their statistical distribution were measured.

RESULTS: The CV changes with force differed between CFS-group and both FM-group and controls (P = 0.01). The CV of the CFS-group increased excessively with force (P < 0.001), whereas that of the controls increased only slightly and non-significantly, and that of the FM-group did not increase at all. In the CFS-group, the number of MUPs conveying very high conduction velocities increased abundantly with force and the MUPs narrowed.

CONCLUSION: Our results suggest disturbed muscle membrane function in CFS patients, in their motor units involved in low force generation. Central neural deregulation may contribute to this disturbance.

SIGNIFICANCE: These findings help to detangle the underlying mechanisms of CFS.

PMID:33639451 | DOI:10.1016/j.clinph.2020.11.043

Surg Oncol. 2021 Feb 20;37:101532. doi: 10.1016/j.suronc.2021.101532. Online ahead of print.

ABSTRACT

BACKGROUND: We identified prognostic factors in a 30-year series of STS treated at a single Institution, using an advanced statistical approach.

METHODS: From June 1988 to July 2019, 164 patients were referred to Rizzoli Orthopedic Hospital, Bologna, Italy) for STS lung metastasectomy (LMTS). The endpoints were lung metastasis recurrence (LMR) and lung metastasis-specific mortality (LMSM). The analysis included directed acyclic graphs, cubic splines, and a competing risk model in order to minimize bias.

RESULTS: The 10- and 15- year LMR cumulative incidence were 0.77 (0.76-0.78) whereas 10- and 15- year freedom from LMSM were 0.60 [0.51-0.70] and 0.56 [0.47-0.67], respectively. The malignant peripheral nerve sheath tumor (MPNST) histotype (SHR 4.12 [2.05-8.27]), a disease-free interval (DFI) up to 68 months (HR from 2 [1.7-2.2] to 1.5 [1.1-1.9]) and a LM size ≥4 mm (3.1 [2.1-4.4]) predicted LMR. Myxofibrosarcoma (HR 2.52[1.64-3.86]), synovial sarcoma (2.53[1.22-5.23]), adjuvant chemotherapy (2.01[1.11-3.61]), DFI between 2 months and 20 months (HR from 1.5 [1.1-2.3] to 1.3 [1.1-1.7] and primary tumor size a primary tumor size comprised between 3.6 cm and 10 cm predicted LMSM. A sharp increase in LMSM was observed with a tumor size from ≥20 cm.

CONCLUSIONS: Our analysis corrected by potential confounders allowed us to identify specific histotypes and DFI intervals as predictors of both LMR and LMSM. Tumor size adjuvant chemotherapy adversely affected LM-related survival. Our findings need to be confirmed by larger randomized studies.

PMID:33639455 | DOI:10.1016/j.suronc.2021.101532

Sci Total Environ. 2021 Feb 17;776:145803. doi: 10.1016/j.scitotenv.2021.145803. Online ahead of print.

ABSTRACT

Information on the transport and distribution of microplastics in coastal lagoons is scarce. This study provides the first evaluation of microplastic distribution in a hypersaline coastal lagoon and explores natural and anthropogenic factors that drive their location and transport. The study combines different field strategies: spatial distribution of microplastics in sediments, for September 2017 (wet season and peak use of the lagoon) and February 2018 (winter season, characterized by intense Northerly winds and least use of the lagoon); spatial distribution of microplastics in the water column in the winter season; ocean-lagoon exchanges of water and microplastics at the lagoon entrance during tidal cycles. Also, one-year records of water level variations along the lagoon provide connections between local pressure gradients and water fluxes. Statistical analyses indicate relationships between temporal variations of microplastic concentrations and human activities. Results show marked seasonality in sources and transport agents. During the summer, microplastics concentration was related to human activities. After this season, the accumulated precipitation in the continental karst region leads to an increase in the water level at the head of the lagoon. The resulting pressure gradient promotes seaward flushing of hypersaline water and of microplastics. At tidal (diurnal) time scales, measurements at the mouth of the lagoon revealed that more particles were collected in ebb than in flood. This variability underscores the need to resolve tidal variability for microplastic sampling in coastal lagoons and estuaries.

PMID:33639458 | DOI:10.1016/j.scitotenv.2021.145803

Sleep Med. 2021 Feb 10;81:62-68. doi: 10.1016/j.sleep.2021.02.001. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of the present study is to assess the psychometric properties of the Sleep Disturbance Scale for Children (SDSC) in an Italian population of infants and toddlers.

METHODS: The SDSC was distributed to the primary caregivers of infants aged 6-36 months recruited via nurseries in the urban area of Rome. Reliability analysis for evaluating internal consistency and item-total correlation coefficients, and factor analysis were performed.

RESULTS: During a 12-months study period, a total of 193 healthy infants (aged 6-36 months) were evaluated using a 22-item version of the SDSC for Italian infants and toddlers. Three of the 22 original items displayed a low item-total correlation (<30) and a low frequency and were eventually removed, resulting in a 19 items questionnaire. Six factors were derived from the factor analysis using the principal component method of extraction and rotated with the varimax method: Difficulty in initiating sleep, Difficulty in maintaining sleep, Sleep breathing disorders, Parasomnias, Disorders of excessive somnolence and Sleep hyperhidrosis. The SDSC adapted for infants and toddlers showed a good level of internal consistency (Cronbach’s alpha: 0.83).

CONCLUSIONS: The statistical analysis, the internal consistency and the factor analysis encourage the use of SDSC as an evaluation tool even at this age. The six factors extracted represent the most common areas of sleep disorders at this age and could therefore help clinicians to detect the areas that need a deeper investigation.

PMID:33639483 | DOI:10.1016/j.sleep.2021.02.001

EBioMedicine. 2021 Feb 24;65:103261. doi: 10.1016/j.ebiom.2021.103261. Online ahead of print.

NO ABSTRACT

PMID:33639399 | DOI:10.1016/j.ebiom.2021.103261

Epilepsy Behav. 2021 Feb 24;117:107809. doi: 10.1016/j.yebeh.2021.107809. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of the study was to determine the impact of a comprehensive inpatient treatment program for persons with epilepsy and intellectual disability (ID) on the concerns of relatives and caregivers, quality of life (QoL), and global health and clinical aspects, assessed by a questionnaire for relatives and caregivers.

METHODS: We performed an open, controlled pre/post study in inpatients with epilepsy and ID or acquired brain damage treated for at least 14 days in a tertiary referral center for epilepsy. Questionnaires were administered to relatives/professional caregivers shortly before admission and 6 months after discharge for the treatment group (TG). The control group (CG) was recruited from the waiting list; questionnaires were answered at the time of application for treatment and 3-6 months later. The questionnaire was the GEOS-43G, the German version of the Glasgow Epilepsy Outcome Scale (GEOS-35), which was extended by eight additional questions from the GEOS-90. Furthermore, QoL, global health, and clinical aspects were assessed using a short questionnaire. Generalized estimation equations (GEEs) were used for statistical analyses.

RESULTS: One-hundred and eight subjects were evaluable in the TG, and 90 in the CG. Concerns about seizures, injuries/risks, medical treatment, diagnostic issues, and the GEOS-43G total score decreased significantly in the TG in contrast to the CG. For the TG, improvements were also significant for global QoL, global health, efficacy, tolerability of AEDs, and for seizure frequency. Caregivers reported larger improvements compared to relatives.

CONCLUSION: The evaluation of the relatives and caregivers in our study indicates that inpatient treatment in a specialized center with a dedicated multi-professional program led to significant improvements regarding the concerns of relatives or caregivers, and in the QoL and related aspects in persons with epilepsy and ID. This shows that specialized inpatient treatment may be helpful for persons with epilepsy and ID.

PMID:33639437 | DOI:10.1016/j.yebeh.2021.107809

Am J Otolaryngol. 2021 Feb 20;42(4):102994. doi: 10.1016/j.amjoto.2021.102994. Online ahead of print.

ABSTRACT

PURPOSE: Analyze Extrusion&Exposion (E&E), its implications in the functional, anatomical results and subjective discomfort in OSA patients treated with Barbed Reposition Pharyngoplasty (BRP).

MATERIALS AND METHODS: 488 patients treated with BRP or multilevel TORS. Stratafix wire was used in 230 patients, V-Loc in 258. E&E, timing and localization evaluated at follow-up. Polygraphy used to assess the impact of E&E on functional results, PPOPS questionnaire used for subjective discomfort.

RESULTS: E&E in the entire group was 18,4%, with significant difference between Stratafix and V-Loc wire (p = 0,002), but not between BRP alone and multilevel surgery (p = 0,68). 28,9% of extrusion happened within the first seven days, 76,7% between seven days and two months, 5,5% after two months. Symptomatic clinical profile has been seen in 62,2%, asymptomatic one in 37,8% of patients. 35,5% of E&E were localized in tonsillar bed, 46,7% in soft palate and 20% in other sites. Mean delta-AHI of E&E patients was -15,87 ± 16.82 compared with one of those who did not have E&E was -16.34 ± 22,77 (p = 0,38). Mean PPOPS of 183 patients analyzed was 12,32 ± 4,96. Mean PPOPS of extruded group was 12,94 ± 4,68 and 11,92 ± 5,11 in not extruded one (p = 0,166).

CONCLUSIONS: E&E are suture-type sensitive (V-Loc > Stratafix), reported more frequent when BRP is performed alone than BRP-TORS with no statistical significance. 76,7% of the E&E occur after patient discharge and within 2 months. About half of the E&E were localized in soft palate. There is no need to fear Extrusion&Exposition because it does not affect in a negative way subjective and PSG outcome.

PMID:33639448 | DOI:10.1016/j.amjoto.2021.102994