Tag: pubmed

World J Surg Oncol. 2025 Feb 10;23(1):46. doi: 10.1186/s12957-025-03652-1.

ABSTRACT

PURPOSE: To explore the application effect of the technique of “priority dissecting of the inferior mesenteric artery combined with complete medial approach (IMA-CMA)” in laparoscopic left-sided colon cancer radical resection.

METHODS: A total of 99 patients who underwent laparoscopic left-sided colon cancer radical resection with splenic flexure mobilization between September 2021 to May 2023 were included. Sixty-eight of these patients were analyzed after propensity score matching (PSM). The perioperative characteristics were compared.

RESULTS: Among these enrolled patients, 45 underwent the traditional approach, and 54 underwent IMA-CMA approach. After PSM, the patients were matched to include 34 patients in each group, with no significant differences in the sex (p = 0.618) or location of tumor (p = 0.798) between the two groups. The patients in IMA-CMA group had shorter operating time (p = 0.032), less intraoperative blood loss (p = 0.003), a higher number of harvested lymph nodes (p = 0.044) and center group lymph nodes(p = 0.037), and a shorter postoperative hospital stay (p = 0.011). Number of positive lymph nodes and postoperative complications were not significantly different between the two groups.

CONCLUSIONS: The technique of IMA-CMA for splenic flexure mobilization is safe and feasible. It can reduce operating time, intraoperative blood loss and postoperative hospital stay, which is conducive to achieving a thorough D3 lymphadenectomy without increasing the incidence of perioperative complications.

PMID:39924496 | DOI:10.1186/s12957-025-03652-1

Int J Psychol. 2025 Apr;60(2):e70020. doi: 10.1002/ijop.70020.

ABSTRACT

Previous research has found an increase in healthcare costs before psychotherapy, followed by a decrease thereafter-a pattern also observed in our sample. However, research on the patterns of change is still lacking. Healthcare quarterly cost patterns of change were examined in a field study of 1508 patients before and during outpatient psychotherapy. Several models assess the patterns of change of the entire sample and in subgroups of those undergoing prolonged psychiatric treatment versus the rest. An exponential pattern (increasing rate of change) had the best fit during the waiting period for the prolonged psychiatric treatment group. A linear pattern was selected for the rest. A logarithmic pattern (decreasing rate of change) best fits the prolonged pharmacotherapy group during therapy. A linear pattern was selected for the rest. The economic implication of the findings is that the prolonged psychiatric treatment group is expected to have the highest return on investment when the waiting period for treatment is shortened. This unique pattern of change may also be a marker of increasing distress in this group while waiting for treatment and the rapid effect that the start of psychotherapy has on this. Therefore this group should be the focus of attention.

PMID:39923260 | DOI:10.1002/ijop.70020

J Physiol Pharmacol. 2024 Dec;75(6). doi: 10.26402/jpp.2024.6.02. Epub 2025 Feb 3.

ABSTRACT

We aimed to evaluate the clinical efficacy of different doses of atorvastatin in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI). In this prospective, randomized controlled study, we enrolled 147 patients with ACS who underwent PCI at our hospital between April 2020 and June 2021. Participants were randomly assigned to three groups based on their post-PCI atorvastatin dose: low-dose (20 mg/day, n=49), medium-dose (40 mg/day, n=49), and high-dose (80 mg/day, n=49). We assessed clinical parameters including blood lipid profiles, inflammatory marker levels, creatine kinase (CK) levels and liver and kidney function before and after atorvastatin treatment. Adverse reactions were monitored to evaluate the safety and efficacy of the different atorvastatin doses. The mean follow-up duration was 13.76±1.27 months (range 12-15 months). No significant differences in baseline blood lipid levels, CK levels and inflammatory markers were observed among the groups (all P>0.05). Post-treatment, the high-dose atorvastatin group showed a more pronounced reduction in blood lipid levels and higher CK levels compared to the medium-dose and low-dose groups. Similarly, the medium-dose group had better outcomes than the low-dose group, with these differences being statistically significant (P<0.05). The high-dose group also exhibited significantly lower levels of inflammatory markers than both the medium-dose and low-dose groups after treatment (P<0.05). Adverse reactions were relatively infrequent across all groups: 4.08% in the low-dose group (1 case of nausea, 1 case of insomnia), 8.16% in the medium-dose group (1 case of insomnia, 1 case of dyspnea, 1 case of nausea, and 1 case of muscular soreness ), and 16.33% in the high-dose group (2 cases of nausea, 1 case of dyspnea, 2 cases of insomnia, and 3 cases of muscular soreness). There was no statistically significant difference in the incidence of adverse reactions among the groups (χ²=4.421, P=0.110). To sum up the results, high-dose atorvastatin significantly improved blood lipid profiles and reduced inflammatory markers in ACS patients following PCI, without adversely affecting liver or kidney function. Furthermore, the high-dose regimen demonstrated a favorable safety profile, suggesting its potential benefit in managing these patients population.

PMID:39923225 | DOI:10.26402/jpp.2024.6.02

J Community Health. 2025 Feb 9. doi: 10.1007/s10900-025-01442-0. Online ahead of print.

ABSTRACT

The growing popularity of electronic cigarettes (e-cigarettes) among Indonesian youth presents a new public health challenge in a country with one of the highest tobacco burdens globally. While tobacco control regulations have been implemented, e-cigarettes remain largely unregulated, raising concerns about their health impacts and youth appeal. This study explores the prevalence, determinants and perceptions of e-cigarette use among high school and university students in Indonesia, providing critical insights to inform effective policymaking. A cross-sectional online-based survey was conducted in 2019 among 158 students aged 15-30 years across 17 provinces in Indonesia. Data on tobacco use behaviours, socioeconomic background, social influences and health perceptions were collected. Descriptive and inferential statistical analyses identified key determinants of e-cigarette use. Among the participants, 36.2% reported ever smoking, and 65.2% of these had tried e-cigarettes. Key determinants of e-cigarette use included male gender, urban residency, peer smoking and social acceptance of smoking (all p < 0.05). Notably, participants commonly perceived e-cigarettes as less harmful than combustible cigarettes and helpful for smoking cessation, despite conflicting scientific evidence. Overall, e-cigarette use is prevalent among Indonesian youth, driven by social and environmental factors, as well as misconceptions about safety. Strengthened regulations and targeted public health campaigns are essential to mitigate the health risks posed by e-cigarettes and enhance tobacco control efforts.

PMID:39923204 | DOI:10.1007/s10900-025-01442-0

J Neuroimaging. 2025 Jan-Feb;35(1):e70019. doi: 10.1111/jon.70019.

ABSTRACT

BACKGROUND AND PURPOSE: This study presents automated atlas-based magnetization transfer (MT) measurements of the typically developing pediatric cervical spinal cord (SC). We report normative MT ratio (MTR) values from the whole cervical cord white matter (WM) and WM tracts, examining variations with age, sex, height, and weight.

METHODS: MT scans of 33 healthy females (mean age = 12.8) and 22 males (mean age = 13.09) were acquired from the cervical SC (C2-C7) using a 3.0 T MRI. Data were processed using the SC Toolbox, segmented, and registered to the PAM50 template. Affine and non-rigid transformations co-registered the PAM50 WM atlas to subject-specific space. MTRs were measured for the specific WM tracts (left and right dorsal fasciculus gracilis, dorsal fasciculus cuneatus, and lateral corticospinal tracts [LCST]) and the whole WM. Descriptive statistics, correlation analysis, and unpaired t-tests (p < 0.05) assessed relationships with age, height, weight, and sex.

RESULTS: Normative MTR measurements were obtained from all regions. The coefficients of variation were low to moderate. No significant differences (p > 0.05) were found across all the cervical levels. However, significant sex differences were observed in whole WM (p = 0.04) and LCST (p = 0.03). MTR values correlated positively with age, with significant correlations at C5 (r = 0.3, p false discovery rate = 0.04). A decreasing trend in MTR values across levels was found for whole WM (r = -0.2, p < 0.001).

CONCLUSIONS: This study provides an understanding of MTR values in pediatric cervical SC and their variations by sex, age, height, and weight, providing a baseline for comparisons in pediatric SC diseases.

PMID:39923194 | DOI:10.1111/jon.70019

J Neuroimaging. 2025 Jan-Feb;35(1):e70024. doi: 10.1111/jon.70024.

ABSTRACT

BACKGROUND AND PURPOSE: Accurate and consistent lesion segmentation from magnetic resonance imaging is required for longitudinal multiple sclerosis (MS) data analysis. In this work, we propose two new transfer learning-based pipelines to improve segmentation performance for subjects in longitudinal MS datasets.

METHOD: In general, transfer learning is used to improve deep learning model performance for the unseen dataset by fine-tuning a pretrained model with a limited number of labeled scans from the unseen dataset. The proposed methodologies fine-tune the deep learning model for each subject using the first scan and improve segmentation performance for later scans for the same subject. We also investigated the statistical benefits of the proposed methodology by modeling lesion volume over time between progressors according to confirmed disability progression and nonprogressors for a large in-house dataset (937 MS patients, 3210 scans) using a linear mixed effect (LME) model.

RESULTS: The results show statistically significant improvement for the proposed methodology compared with the traditional transfer learning method using Dice (improvement: 2%), sensitivity (6%), and average volumetric difference (16%), as well as visual analysis for public and in-house datasets. The LME result showed that the proposed subject-wise transfer learning method had increased statistical power for the measurement of longitudinal lesion volume.

CONCLUSION: The proposed method improved lesion segmentation performance and can reduce manual effort to correct the automatic segmentations for final data analysis in longitudinal studies.

PMID:39923192 | DOI:10.1111/jon.70024

J Nepal Health Res Counc. 2024 Dec 20;22(3):627-631. doi: 10.33314/jnhrc.v22i03.5406.

ABSTRACT

BACKGROUND: Total extra peritoneal inguinal hernia repair is established approach to inguinal hernia repair usually performed under general anesthesia. Aim of the study was to compare Total extra peritoneal inguinal hernia repair outcome when operated under spinal anesthesia and general anesthesia.

METHODS: A prospective cross-sectional study was conducted at Bir hospital on patients undergoing Total extra peritoneal inguinal hernia repair under either spinal anesthesia or general anesthesia for inguinal hernia from September 2022 to August 2023. Operative time, postoperative hospitalization time, postoperative pain, postoperative adverse effects, level of satisfaction and recurrence rate at one year was compared.

RESULTS: Fifty-eight patients were included, divided into two groups TEP-GA and TEP-SA, 29 in each arm. All procedures were completed by allocated method of anesthesia. Though pain score was low in TEP-SA in initial four hours, 2.79±1.08 (GA) and 1.99±0.97 (SA) and 2.28±1.09 (GA) and 1.80±0.80 (SA) at one and four hours post-operative respectively, no statistical difference was noted between two groups regarding surgery time, pain score complications, hospital stay, recovery or recurrence.

CONCLUSIONS: Spinal anesthesia is at par with general anesthesia for total extra peritoneal inguinal hernia repair, if not better. It may be appropriate anesthetic modality in patients considered high risk for general anaesthesia.

PMID:39923179 | DOI:10.33314/jnhrc.v22i03.5406

J Nepal Health Res Counc. 2024 Dec 20;22(3):616-621. doi: 10.33314/jnhrc.v22i03.5330.

ABSTRACT

BACKGROUND: Medical student syndrome (MSS) entails the development of symptoms of the same disease as the one being studied in medical students. This study aimed to determine the prevalence of Medical student syndrome among medical students in Nepal and identify associated factors.

METHODS: A Cross-sectional study was conducted at Lumbini Medical College Palpa, Nepal on medical students. Google form-based questionnaire was made, and the link was distributed to the students. A cut-off score was derived for Medical student syndrome. Students whose scores exceeded this threshold were categorized as having experienced Medical student syndrome. The responses received from the consenting students were downloaded in a Microsoft Excel spreadsheet and exported to SPSS v 26 and analysed.

RESULTS: The overall prevalence of Medical student syndrome was 17.8%. There was no significant difference in Medical student syndrome scores between genders (p = 0.801). However, year of study significantly influenced Medical student syndrome scores (p = 0.001, η² = 0.069), with final year students reporting higher scores.

CONCLUSIONS: This cross-sectional study revealed a significant prevalence of Medical Student Syndrome among medical students in Nepal, with nearly 18% reporting symptoms of the condition.

PMID:39923177 | DOI:10.33314/jnhrc.v22i03.5330

J Nepal Health Res Counc. 2024 Dec 20;22(3):602-607. doi: 10.33314/jnhrc.v22i03.5303.

ABSTRACT

BACKGROUND: Monitoring during treatment of asthma is usually done by various clinical tools, spirometry, sputum eosinophils and fractional exhaled nitric oxide. Fractional exhaled nitric oxide is a simple and noninvasive tool and has a good agreement with asthma control test score. This study aims to correlate fractional exhaled nitric oxide with asthma control test score.

METHODS: This cross-sectional study was conducted at National Academy of Medical Sciences, Bir hospital, Chest unit, Department of Medicine, over a duration of six months. Patients aged more than 18 years with bronchial asthma diagnosed at least three months prior were included into the study. Those with recent severe exacerbations, known other chronic respiratory disease and smokers were excluded. Asthma control test score was obtained at baseline. All included patients underwent fractional exhaled nitric oxide measurement followed by measurement of Forced vital capacity(FVC) Forced expiratory volume in one second (FEV1) and FEV1/FVC ratio.

RESULTS: Forty patients with a mean age of 40.5±11.1 years were included in the study. Majority were females (65%) and the median duration of symptoms was 24 months (Interquartile range= 18-60). Mean fractional exhaled nitric oxide level was 27.8 (±16.0) parts per billion (ppb) and asthma control test score was 19.3 (±4.7). Mean fractional exhaled nitric oxide levels were significantly different across different severity (well controlled, partially controlled and poorly controlled) of asthma (p=0.013). The mean fractional exhaled nitric oxide values and total asthma control test score shows statistically significant negative correlation (Pearson correlation coefficient (r) = -0.462, p=0.003). Asthma control test and FeNO values guided the change of inhaled steroid dose in 17 of the 40 patients.

CONCLUSION: Fractional exhaled nitric oxide can be used when available, along with asthma control test for monitoring control and adjusting the inhaled steroid dose in asthma.

PMID:39923175 | DOI:10.33314/jnhrc.v22i03.5303

J Nepal Health Res Counc. 2024 Dec 20;22(3):582-591. doi: 10.33314/jnhrc.v22i03.5238.

ABSTRACT

BACKGROUND: Hypertension is a major risk factor for cardiovascular diseases, chronic kidney disease, and dementia. Early detection and management are crucial for preventing these complications. However, many people lack awareness regarding their blood pressure. The study aimed to assess the prevalence of hypertension and its associated factors in rural communities.

METHODS: This cross-sectional study was conducted among 525 middle-aged (35-60 years) residents of the Rupa Rural Municipality, Nepal, from August to December 2020. Chi-square test and multivariate logistic regression were performed to identify the factors associated with hypertension at a 5% level of significance.

RESULTS: More than half (50.9%) of the respondents had normal to elevated systolic pressure, while only one-third (33.9%) had normal to elevated diastolic pressure. Only 47.4% of the hypertensive participants were aware of their hypertensive condition. Being a male (aOR: 1.903; 95% CI: 1.184-3.030), in middle age of 45-55 years (aOR: 2.002; 95% CI: 1.152-3.478), having basic education (aOR: 2.014; 95% CI:1.174-3.455), currently consuming alcohol (aOR: 1.923; 95% CI: 1.095-3.375), and being overweight/ obese (aOR: 1.899; 95% CI: 1.262-2.859) were identified as significant factors associated with hypertension.

CONCLUSIONS: The studys findings emphasize the urgency of interventions to improve awareness of hypertension and its management to improve health outcomes. Targeted interventions will have an opportunity to reduce the burden of hypertension which is an important risk factor for cardiovascular diseases among the middle-aged population.

PMID:39923173 | DOI:10.33314/jnhrc.v22i03.5238