Tag: nevin manimala

Zhongguo Fei Ai Za Zhi. 2021 Jun 14. doi: 10.3779/j.issn.1009-3419.2021.102.17. Online ahead of print.

ABSTRACT

BACKGROUND: The mortality of lung cancer ranks first among all malignant tumors, but there are few studies on the effect of different segmentectomy on lung function in patients with early lung adenocarcinoma. The purpose of this study was to evaluate the degree of lung function preservation and short-term results of preoperative planning combined with fluorescence thoracoscopic precision segmentectomy and traditional segmentectomy in patients with early lung adenocarcinoma.

METHODS: From January 1, 2020 to October 31, 2020, 60 patients underwent thoracoscopic segmentectomy in the Department of Thoracic Surgery of the First Affiliated Hospital of University of Science and Technology of China: 30 patients in precision segmentectomy group and 30 patients in traditional segmentectomy group. The clinicopathological features, perioperative data and postoperative pulmonary function of the two groups were compared.

RESULTS: The operation time of the precision group was shorter than that of the traditional group, and the difference was statistically significant (P<0.05). The preoperative pulmonary function accuracy group and the traditional group in forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and carbon monoxide diffusing capacity (DLCO) were (3.65±0.63)L vs (3.54±0.64)L, (2.72±0.50)L vs (2.54±0.48)L and (20.36±3.02)mL/mmHg/min vs (19.16±3.18)mL/mmHg/min, respectively. One month after operation, the FVC, FEV1 and DLCO of pulmonary function accuracy group and traditional group were (3.35±0.63)L vs (2.89±0.57)L, (2.39±0.54)L vs (2.09±0.48)L and (17.43±3.10)mL/mmHg/min vs (15.78±2.865mL/mmHg/min, respectively. Three months after operation, the FVC and DLCO of pulmonary function accuracy group and traditional group were (3.47±0.63)L vs (3.20±0.56)L and (19.38±3.02)mL/mmHg/min vs (17.79±3.21)mL/mmHg/min, respectively.

CONCLUSIONS: Preoperative planning combined with fluorescence thoracoscopic precise segmentectomy provides advantages in intersegmental plane recognition, vascular anatomy and postoperative recovery, which significantly shortens the operation time and makes the treatment more accurate.

PMID:34120431 | DOI:10.3779/j.issn.1009-3419.2021.102.17

Korean J Ophthalmol. 2021 Jun;35(3):188-197. doi: 10.3341/kjo.2020.0135. Epub 2021 Jun 4.

ABSTRACT

PURPOSE: To compare the efficacy of 0.1% nepafenac and 1% prednisolone acetate eye drop in postoperative inflammation control in micro-incisional cataract surgery.

METHODS: We conducted a prospective, randomized, comparative, single-blind study. All the patients underwent temporal 2.2-mm micro-incisional cataract surgery. They were randomized into two groups (group A and B). Group A received 0.1% nepafenac eye drops 4 times/day for 4 weeks and group B received 1% prednisolone acetate eye drops in tapering doses for 4 weeks after surgery. Both the groups received moxifloxacin 0.5% eye drops 4 times/day for 2 weeks. Patients were examined on 1st, 7th, and 30th postoperative days and parameters of postoperative inflammation were evaluated and noted at each visit.

RESULTS: A total of 200 patients were enrolled in the study. However, five patients lost to follow up, group A had 97 and group B had 98 patients respectively. Results were statistically insignificant in terms of the difference in lid edema, conjunctival congestion, corneal edema, anterior chamber cells and flare between the two groups with p-values >0.05 for each parameter at each visit. However, the difference in mean central macular thickness between the groups was significant (205.713 ± 17.14 vs. 220.984 ± 32.83 in group A and B, respectively, p ≤ 0.001) at 1 month. Also, the mean pain score was significantly lower (p = 0.018) in the nepafenac group at day 7 of surgery.

CONCLUSIONS: Nepafenac is equally effective and non-inferior to prednisolone acetate in suppression and prevention of inflammation in postoperative period.

PMID:34120417 | DOI:10.3341/kjo.2020.0135

Korean J Ophthalmol. 2021 Jun;35(3):207-214. doi: 10.3341/kjo.2020.0124. Epub 2021 Jun 4.

ABSTRACT

PURPOSE: To describe the development of multiple retinal hemorrhages after uncomplicated macular hole (MH) surgery, and to determine the associated factors.

METHODS: The medical records of 163 patients (167 eyes) diagnosed with idiopathic MHs and who underwent surgery at Pusan National University Hospital between March 2016 and July 2018 were retrospectively reviewed. The development of retinal hemorrhages was evaluated using ultra-widefield fundus photographs. Multiple retinal hemorrhages were defined as three or more dot or blot hemorrhages that had not been observed before and during the surgery. The patients were divided into two groups according to the presence of multiple retinal hemorrhages. The variable parameters were compared between the two groups to find the risk factors. The associated factors were evaluated further for the independent factor using multiple logistic regression analysis.

RESULTS: Multiple retinal hemorrhages were observed in 31 eyes (18.6%) after MH surgery. The associated factors were the surgical induction of posterior vitreous detachment (PVD) (p = 0.003), use of the internal limiting membrane flap technique (p = 0.028), and staining with Brilliant Blue G (BBG) (p = 0.003). Retinal hemorrhages were exclusively observed in eyes in which BBG was used. Surgical PVD induction was the only independent risk factor (odds ratio, 13.099; p = 0.013). No statistically significant differences were observed between the two groups in the postoperative visual outcomes and MH closure rate. Additionally, patients who underwent surgery for idiopathic epiretinal membrane during the study period were reviewed to validate the above findings. Multiple retinal hemorrhages were noted in only one case (0.4%) in which BBG was used after surgical induction of PVD.

CONCLUSIONS: Multiple retinal hemorrhages after MH surgery appear to be related to the intravitreal use of BBG in eyes that sustained mechanical damage because of surgical induction of PVD; however, they did not affect surgical outcomes.

PMID:34120419 | DOI:10.3341/kjo.2020.0124

Korean J Ophthalmol. 2021 Jun;35(3):235-241. doi: 10.3341/kjo.2021.0010. Epub 2021 Jun 4.

ABSTRACT

PURPOSE: To evaluate the safety and efficacy of preservative-free (PF) latanoprost in glaucoma patients.

METHODS: In this prospective, open-label, observational study, a total of 27 primary open-angle glaucoma patients who used benzalkonium chloride-preserved prostaglandin analogues for at least 6 months were enrolled. After changing the eye drops to PF lataprost, the intraocular pressure (IOP) and ocular surface symptoms and signs were evaluated in all patients on days 0 (first visit, D0), 45 (D45), and 90 (D90).

RESULTS: Mean IOP remained stable during the study period (14.0 ± 2.4 mmHg at D0, 13.9 ± 2.0 mmHg at D45, 13.7 ± 2.2 mmHg at D90; p = 0.603). Mean deviation, pattern standard deviation, and best-corrected visual acuity were similar before and after eye drops replacement. Bulbar conjunctival hyperemia, corneal staining, and conjunctival staining were significantly decreased over 90 days (p = 0.025, p < 0.001, p = 0.020, respectively). The ocular surface disease index score showed a statistically significant improvement from 26.4 ± 18.5 at D0 to 19.8 ± 17.0 at D45 and 15.7 ± 15.6 at D90 (p < 0.001). In the evaluation of ocular tolerability, burning symptoms and dryness were significantly decreased (p = 0.001, p = 0.040).

CONCLUSIONS: The effects of PF latanoprost on reducing IOP were comparable with those of benzalkonium chloride-preserved prostaglandin analogues, but side effects on the ocular surface were much less pronounced when PF latanoprost was used. With this efficacy, PF latanoprost could slow the progression of glaucoma by increasing patient compliance.

PMID:34120423 | DOI:10.3341/kjo.2021.0010

Int J Clin Pract. 2021 Jun 13:e14522. doi: 10.1111/ijcp.14522. Online ahead of print.

ABSTRACT

OBJECTIVE: To generate real-world evidence (RWE) from the United States to assess the impact of pill burden and the importance of achieving stable daily dose of sertraline (time taken, number of dose adjustments needed) on adherence/persistence and healthcare resource utilization (HCRU).

METHODS: Retrospective analysis of the PharMetrics® Plus database (Oct/1/2012-Mar/31/2020) in the United States. Eligible patients had major depressive disorder (MDD) or obsessive-compulsive disorder (OCD) and ≥1 claim for sertraline during index period (Apr/1/2013-Mar/31/2019, allowing 6-months prior, 1-year post-index follow-up). Patients who achieved stable daily dose of sertraline (>90-days on same dose) were categorized into five cohorts, depending on pill burden/daily dose: Cohort 1: 1×50mg/day; Cohort 2: 1×100mg/day; Cohort 3: 2×50mg/day; Cohort 4: 1.5×100mg/day; Cohort 5: 3×50mg/day. Impact of pill burden on adherence/persistence and HCRU were assessed among cohorts using logistic regression analysis, and between patients who did vs. did not stabilize on therapy. P<0.05 was considered significant for all analyses.

RESULTS: Of 224,412 eligible patients, 108,729 stabilized on sertraline (50, 100, 150mg/day) and formed Cohorts 1-5. Stabilized patients on lower pill burden had statistically higher adherence and were more likely to remain persistent throughout 1-year post-index period vs. patients on higher pill burden but same overall dose (100mg/day [Cohort 2 vs. 3]; 150mg/day [Cohort 4 vs. 5]; respectively). Patients who did not stabilize had significantly lower adherence/persistence vs. patients who achieved stable daily dose (Cohorts 1-5 combined). Persistence improved when stable daily dose was achieved quickly (within 1-4 months) and efficiently (within 1-3 dose adjustments). Probability of HCRU increased for patients who did not stabilize on their initial prescription.

CONCLUSION: Simplifying treatment regimen and decreasing pill burden improved adherence and/or persistence with sertraline therapy (100 or 150mg/day). Patients achieving stable daily dose of sertraline in an efficient and timely manner were more likely to remain persistent throughout 1-year follow-up.

PMID:34120397 | DOI:10.1111/ijcp.14522

Dent Traumatol. 2021 Jun 13. doi: 10.1111/edt.12687. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are complex problems where lack of proper care may result in serious complications. The need to improve the management of TDI is a frequently addressed concern. Methods of improvement in their diagnosis and management are continuously evolving. The interactive Internet tool, the Dental Trauma Guide (DTG), helps to simplify diagnostic and management dilemmas. However, it is not a freely available tool. The aim of the current study was to assess the knowledge and diagnostic skills of undergraduate dental students with access to the DTG compared with students without such access, in order to validate and promote this tool in dental education.

MATERIALS AND METHODS: Two groups of students were randomly selected where one group of final year dental undergraduate students were exposed to lectures, demonstrations, discussions and tutorials on the management of TDI according to the standard undergraduate curriculum in Sri Lanka. Another test group of 21 students were provided with access to DTG during their training in paediatric dentistry. At the end of the study period, students were assessed on their knowledge of TDI using MCQs (Multiple Choice Questions) and OSCEs (Objective Structured Clinical Examination), based on the DTG.

RESULTS: The students with access to the DTG were more knowledgeable in providing the correct answers to three out of the seven OSCE questions. Evaluation based on the MCQs did not reveal a significant difference (p = .913). However, users of the DTG showed a statistically significant difference with better overall knowledge based on their answers (p = .028). Following this period of evaluation, all of the students were provided with access to the DTG to supplement their learning experience.

CONCLUSION: The Dental Trauma Guide is a useful supplementary tool for undergraduate students to arrive at a correct diagnosis and treatment plan for TDI.

PMID:34120401 | DOI:10.1111/edt.12687

Pediatr Transplant. 2021 Jun 13:e14065. doi: 10.1111/petr.14065. Online ahead of print.

ABSTRACT

BACKGROUND: The number of programs offering a PTH fellowship has grown rapidly over the last 10 years. This study aimed to describe the clinical, didactic, procedural, and research experiences of recent PTH fellowship graduates. In addition, we sought to understand graduates’ post-fellowship professional responsibilities and their perception about the utility of the PTH fellowship.

METHODS: An anonymous survey was distributed from February to October 2020 through REDCap to all recent graduates (2015-2019) of an ACGME-approved PTH fellowship program. The survey consisted of 49 questions focused on the PTH fellowship experience. Results were summarized using descriptive statistics.

RESULTS: Thirty-eight of 43 graduates (88%) responded to the survey representing 12 PTH fellowship programs. The didactic experience varied; 97% received pathology lectures, 81% radiology lectures, 54% organ allocation lectures, 54% procedural lectures, 57% immunology lectures, and 43% live donation lectures. During the PTH fellowship, the majority of fellows performed >10 liver biopsies (82%) and >5 variceal bandings (58%); however, 63%, 32%, 8%, and 8% never performed paracentesis, variceal sclerotherapy, variceal banding, and liver biopsies, respectively. The majority of fellows (95%) completed a research project during PTH fellowship. Currently, 84% of graduates are employed at a transplant academic institution. All graduates recommended the fellowship.

CONCLUSIONS: There is variability in the didactic, clinical, and procedural training among PTH fellowship programs. Although uniformly viewed as a beneficial fellowship year, there is an opportunity to collaborate to create a more standardized training experience.

PMID:34120405 | DOI:10.1111/petr.14065

Int J Clin Pract. 2021 Jun 13:e14524. doi: 10.1111/ijcp.14524. Online ahead of print.

ABSTRACT

INTRODUCTION: In this study, it is planned to compare the RT-PCR test, which is the gold standard in the diagnosis of COVID-19, with Thorax computed tomography (CT) and rapid antibody test results.

METHODS: Patients who were admitted to the emergency service of İzmir Çiğli Training and Research Hospital between 01.04.2020 and 31.05.2020 and who were suspected of having COVID-19 infection were included in the study. The medical records of the patients were retrospectively analyzed through the hospital data processing database. Age, gender, hospitalization, status of home quarantine, real-time reverse transcription-polymerase chain reaction (RT-PCR), thorax CT and rapid antibody test results of the patients were examined. The relationship between RT-PCR, thorax CT and rapid antibody test results were compared statistically.

RESULTS: A total of 181 patients, 115 (63.5%) male and 66 (36.5%) female, with an average age of 56.4 ± 18.06 years were included in the study. The nasopharyngeal swab PCR result obtained at the first admission of the patients to the emergency department was positive in 71 (39.2%) patients. Rapid antibody tests performed at hospital admission were positive in 57 (31.5%) patients. Thorax CT was performed in 173 (95.6%) patients who applied to the emergency department, and 112 (64.7%) of them had findings that could be compatible with COVID-19. According to the thorax CT findings in patients, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting COVID-19 infection were respectively; 76.1%, 43.1%, 48.2% and 72.1% (ĸ: 0.176, p <0.001). According to the rapid antibody test results, sensitivity, specificity, PPV and NPV for detecting COVID-19 infection were 57.5%, 85.5%, 71.9% and 75.8%, respectively (ĸ: 0.448, p <0.001). In our study, the mortality rate for COVID-19 was found to be 2.8%.

CONCLUSION: Rapid antibody test and thorax CT examinations were found to have low diagnostic value in patients who admitted to the emergency department of our hospital and whose first RT-PCR SARS-CoV-2 test was positive. Studies involving larger patient groups are needed for their use alone in diagnosis and screening.

PMID:34120388 | DOI:10.1111/ijcp.14524

Int J Clin Pract. 2021 Jun 13:e14520. doi: 10.1111/ijcp.14520. Online ahead of print.

ABSTRACT

AIMS: Recurrent pregnancy loss (RPL) is usually defined by two or more consecutive clinical miscarriages, which causes psychological trauma for couples. In this study, we aimed to investigate the predictive role of Fibrinogen to albumin ratio (FAR) in patients with RPL.

METHODS: Pregnant women in their first trimester of pregnancy were included in the study and divided in to two groups as RPL patients (n:44) and patients with no previous recurrent miscarriage (n:60) as control group. Demographical parameters and routine blood parameters (fibrinogen, D-dimer, fibrinogen to albumin ratio (FAR), neutrophil to lymphocyte ratio (NLR), platelet count, main platelet volume (MPV), and red cell distribution width (RDW) values) were compared between the RPL group and the control group.

RESULTS: The groups were determined to be statistically different in regards to gravidity and parity (p<0.001). The difference between the groups was statistically different in regards to fibrinogen (mg/dl), albumin (g/dl), FAR (%), NLR (%), RDW-coefficient of variation (CV) (%), RDW-standard deviation (SD) (fL), and platelet counts (10^-3 / uL). However, MPV (fL) and D-dimer (ug/L) levels were similar in both groups. The receiver operating characteristic (ROC) curve analysis revealed that the NLR levels were 84.1% sensitive and 75% specific with a cut-off value of 4.27 and the FAR levels were 79.5% sensitive and 88.3% specific with a cut-off value of 105.69 for predicting RPL.

CONCLUSION: Our results indicate that the FAR and NLR levels seem to be effective parameters for predicting RPL with high sensitivity and specificity.

PMID:34120391 | DOI:10.1111/ijcp.14520

Alcohol Clin Exp Res. 2021 Jun 12. doi: 10.1111/acer.14649. Online ahead of print.

ABSTRACT

BACKGROUND: Posttraumatic Stress Disorder (PTSD) often co-occurs with increased alcohol consumption (AC) and alcohol use disorder (AUD), however it is unknown whether the same etiologic influences underlying PTSD-AUD comorbidity are those underlying PTSD and AC.

METHODS: This study used large-scale genome wide association study (GWAS) data to test if PTSD and drinks per week [DPW]/AUD are causally related to one another, and if so, if PTSD precedes DPW/AUD and/or vice versa, using Mendelian Randomization on European ancestry GWAS summary statistics from the Psychiatric Genomics Consortia (PGC; PTSD), GWAS & Sequencing Consortium of Alcohol and Nicotine Use (GSCAN; DPW), and Million Veteran Program (MVP; AUD).

RESULTS: PTSD exerted a potentially causal effect on AUD (beta= 0.039, se= 0.014, p= 0.005), but not on DPW (beta= 0.002, se= 0.003, p= 0.414). Additionally, neither DPW (beta= 0.019, se= 0.041, p= 0.637) nor AUD (beta= 8.87×10^-4 , se= 0.001, p= 0.441) exerted a causal effect on PTSD.

CONCLUSIONS: These findings are consistent with the self-medication model, in which individuals misuse alcohol as a way of coping with aversive trauma-related symptoms. These findings extend latent and molecular findings of shared and correlated risk between PTSD and alcohol phenotypes. Given the health behaviors associated with these phenotypes, these findings are important in that they suggest groups on which to prioritize prevention efforts. Further, they provide a rationale for future pre-clinical and clinical studies examining the biological mechanisms by which PTSD may impact AUD.

PMID:34120358 | DOI:10.1111/acer.14649