Tag: pubmed

Spine Deform. 2024 Dec 24. doi: 10.1007/s43390-024-01027-2. Online ahead of print.

ABSTRACT

PURPOSE: To assess the radiological outcomes and complications focusing on distal junctional failure (DJF) of adult spinal deformity patients who underwent thoracolumbar fixation with the use of offset sublaminar hooks (OSH) distally.

METHODS: Retrospective review of a prospective, multicenter adult spinal deformity database (2 sites). Inclusion criteria were age of at least 18 years, presence of a spinal deformity with thoraco-lumbar instrumentation ending distally with OSH (pelvis excluded), with minimum 2 years of follow-up. Demographic data, spinopelvic parameters, functional outcomes and complications were collected. Data was analyzed using descriptive statistics. Statistical significance was set to p < 0.05.

RESULTS: 32 patients met the inclusion criteria, with the main etiologies being Scheuermann kyphosis and post-traumatic kyphosis. There was a significant correction of thoracic or thoraco-lumbar kyphosis (from 83° to 45° in case of posterior column osteotomy, p < 0.001, and from 49° to 11° in case of a three-column osteotomy, p < 0.001). DJF occurred in 9.3% of the patients including 1 patient who presented distal hook dislodgement and 2 patients who presented a compression fracture below the lowest instrumented vertebra. Oswestry Disability Index score improved in the majority of the patients (from 34.3 to 18.1, p < 0.05).

CONCLUSIONS: This is the first paper to propose offset sublaminar hook as a safe and efficient tool for protection of the distal end of the construct in kyphotic ASD surgery when not going down to the pelvis. It showed satisfactory radiological and clinical outcome with an acceptable rate of complications and no distal junctional failure that required revision surgery.

PMID:39718744 | DOI:10.1007/s43390-024-01027-2

Acta Neurol Belg. 2024 Dec 24. doi: 10.1007/s13760-024-02711-w. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this meta-analysis was to conduct a comparative study by systematically examining and analyzing trials that studied the impacts of levodopa and bromocriptine, either separately or together, in treating Parkinson’s disease (PD).

METHODS: An extensive literature search was conducted across PubMed (Medline), Scopus, and Web of Science databases, using targeted keywords for studies published up to October 2024. The methodological quality of included RCTs was assessed with the Cochrane Risk of Bias 2 (RoB 2) tool, and bias evaluation was performed using RevMan (version 5). Statistical analyses were conducted in STATA version 17, applying random-effects models. The overall quality of evidence was evaluated using the GRADE approach.

RESULTS: The thorough evaluation identified 12 randomized controlled trials with a total of 4,060 participants, 1,956 in the intervention group and 2,104 in the comparison group, all diagnosed with PD. A combined effect size of 0.18 (SMD: 0.18; 95% CI: -0.03, 0.39) was found through quantitative analysis of motor scales for the Unified Parkinson’s Disease Rating Scale (UPDRS). An effect size of 0.50 (OR: 0.50; 95% CI: 0.31, 0.80) was determined for dyskinesia. Dystonia occurrences showed a significant effect size of 0.44 (OR: 0.44; 95% CI: 0.24, 0.81; I2: 87.28%; P value: 0.0001). Hallucination and dizziness occurrences showed effect sizes of 0.91 (OR: 0.91; 95% CI: 0.36, 2.30) and 1.36 (OR: 1.36; 95% CI: 0.91, 2.04) overall, respectively. Quality assessment revealed high-certainty evidence for dyskinesia and dystonia reduction with bromocriptine, while other outcomes showed low to very low certainty. Meta-regression analyses showed no significant correlation between population characteristics and outcomes.

CONCLUSION: This thorough meta-analysis offers an understanding of how bromocriptine compares in effectiveness to levodopa and other treatments for managing PD.

PMID:39718740 | DOI:10.1007/s13760-024-02711-w

Cell Oncol (Dordr). 2024 Dec 24. doi: 10.1007/s13402-024-01019-4. Online ahead of print.

ABSTRACT

PURPOSE: Our study aims to develop and validate a novel molecular marker for the prognosis and diagnosis of hepatocellular carcinoma (HCC) MATERIALS & METHODS: We retrospectively analyzed mRNA expression profile and clinicopathological data of HCC patients fetched from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO) and The International Cancer Genome Consortium (ICGC) datasets. Univariate Cox regression analysis was performed to collect differentially expressed mRNA (DEmRNAs) from HCC and non-tumor tissues, and YEATS2, a prognostic marker, was identified by further analysis. ROC curve, survival analysis and multivariate Cox regression analysis as well as nomograms were used to evaluate the prognosis of this gene. Finally, the biological function of this gene was preliminarily discussed by using single gene Gene Set Enrichment Analysis (GSEA), and the YEATS2 overexpression and knockdown hepatoma cell line was used to verify the results in vitro and in vivo.

RESULTS: Based on the clinical information of HCC in TCGA, GEO and ICGC databases, the gene YEATS2 with significant differences from HCC was identified. There was a statistical difference in the survival prognosis between the two databases and the ROC curve showed that the survival of HCC in both TCGA, GSE14520 and ICGC groups had a satisfactory predictive effect. Univariate and multivariate Cox regression analysis showed that YEATS2 was an independent prognostic factor for HCC, and Nomograms, which combined this prognostic feature with significant clinical features, provided an important reference for the clinical prognostic diagnosis of HCC. Next, we constructed overexpression and knockdown YEATS2 cell line in Hep3B and LM3 cells, and further proved that overexpression YEATS2 promote the proliferation and migration of HCC cells by CCK8, colony formation experiment, and transwell assays, and knockdown YEATS2 inhibited the proliferation and migration of HCC cells by CCK8, colony formation experiment, and transwell assays. Finally, the biological function of YEATS2 was preliminarily explored through GSEA analysis of a single gene, and it was found that it was significantly correlated with cell cycle and DNA repair, which provided us with ideas for further analysis. Furthermore, the knockdown of YEATS2 promoted radiation-induced DNA damage, enhanced radiosensitivity, and ultimately inhibited the proliferation of hepatocellular carcinoma cells in vitro and in vivo.

CONCLUSIONS: Our study identified a promising prognostic marker for hepatocellular carcinoma that is useful for clinical decision-making and individualized treatment.

PMID:39718737 | DOI:10.1007/s13402-024-01019-4

Clin Exp Nephrol. 2024 Dec 24. doi: 10.1007/s10157-024-02612-5. Online ahead of print.

ABSTRACT

BACKGROUND: Patients diagnosed with congenital kidney malformations are at an increased risk of developing hypertension, proteinuria, and progressing to chronic kidney disease (CKD). The present study aimed to determine the frequency of masked hypertension and ambulatory arterial stiffness index (AASI) in patients with congenital kidney malformations.

METHODS: The study included 174 patients with congenital kidney malformations (48 patients with unilateral renal agenesis (URA), 40 patients with ectopic kidney (EK), 36 patients with horseshoe kidney (HK), 31 patients with multicystic dysplastic kidney (MCDK), 19 patients with unilateral renal hypoplasia (URH), and 45 healthy controls.

RESULTS: The mean age was 12.9 ± 2.9 years, and the male-to-female ratio was 1.5. No significant differences were observed between the congenital kidney malformations groups concerning age, sex, follow-up period, proteinuria, or estimated glomerular filtration rate (eGFR) (P > 0.05). Nevertheless, the prevalence of masked hypertension exhibited a statistically significant increase in the congenital kidney malformations groups (except the URH group) compared to the control group (P < 0.05). The AASI was significantly greater in the congenital kidney malformations groups than in the control group (P < 0.05). The nighttime diastolic blood pressure (DBP), mean arterial pressure (MAP), and DBP index were significantly different between the congenital kidney malformations groups (P < 0.05). However, there were no significant differences in nondipping pattern, proteinuria, or masked hypertension between the congenital kidney malformations groups.

CONCLUSIONS: Patients with congenital kidney malformations should be periodically evaluated throughout life for BP. Based on the present findings, we strongly recommend ABPM for the diagnosis of masked hypertension and outcomes, including AASI score.

PMID:39718736 | DOI:10.1007/s10157-024-02612-5

Cancer Causes Control. 2024 Dec 24. doi: 10.1007/s10552-024-01933-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The prevalence of smokeless tobacco consumption remains high despite policies on reduction interventions. This study aims to quantify the associations between smokeless tobacco use with cancer incidence and mortality globally.

METHODS: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and PROSPERO protocol (ID: CRD42023390468). A comprehensive literature search was performed using PubMed, Web of Science, and Scopus databases, covering the period from January 1, 2000, to February 28, 2023. We included peer-reviewed observational studies, specifically case-control and cohort studies, where smokeless tobacco use was the primary exposure and cancer incidence, or mortality were the main outcomes. Three independent reviewers screened titles, abstracts, and full texts, and extracted data from the included studies. Risk of bias was assessed by the same three reviewers. Any disagreements were resolved through discussion with a fourth reviewer. We performed random-effects meta-analyses and assessed heterogeneity and publication bias to ensure the robustness of our findings.

RESULTS: Of the 3,611 articles identified, 80 were included in the final analysis. Increased risks were observed for cancer mortality [Risk Ratio (RR) 1.38, 95% Confidence Interval (CI) 1.22-1.56] and incidence [RR 1.17, 95% CI 1.08-1.27]. The specific cancer sites with increased mortality risk included head and neck cancers, as well as stomach cancer. For cancer incidence, associations were observed with head and neck, oral, esophageal, stomach, and pancreatic cancers. Significant heterogeneity (I² statistic 65% to 90%) was observed among most cancer outcomes.

CONCLUSION: Our study found significant associations between smokeless tobacco use and cancer incidence and mortality. Targeted policy interventions, such as stricter regulations on smokeless tobacco use, are recommended to reduce its consumption and mitigate the associated cancer risks.

PMID:39718727 | DOI:10.1007/s10552-024-01933-w

Eur J Orthop Surg Traumatol. 2024 Dec 24;35(1):47. doi: 10.1007/s00590-024-04144-w.

ABSTRACT

PURPOSE: To assess the rate of heterotopic ossification (HO) following acetabular surgery with a standardized protocol via the Kocher-Langenbeck. Secondarily, to evaluate patient characteristics, injury variables, and perioperative data among patients with HO and no HO.

METHODS: This was a retrospective case series from an academic Level I trauma center. Included patients had displaced acetabular fractures treated via Kocher-Langenbeck approach with debridement of (1) gluteus minimus muscle (GMM) from the posterior wall and column up to the superior gluteal neurovascular bundle, (2) unhealthy appearing piriformis muscle without fascial disruption, and (3) superior and inferior gemelli in the location of implant placement. Those with posterior hip dislocations and gluteus medius injury received prophylactic indomethacin.

RESULTS: Fifty-seven patients met inclusion criteria. Thirteen patients (22.8%) developed HO, and 44 patients (77.2%) had no evidence of HO. Ten (17%) patients developed mild HO (Brooker classification (BC) I/II), 3 (5%) developed moderate HO (BC III), and no patients developed severe HO (BC IV). There were no differences in the prevalence of elementary versus associated acetabular fracture patterns or individual fracture patterns among cohorts. Patients with HO had longer times to surgical intervention (5.3 ± 5.1 days vs. 2.4 ± 1.6 days, p = 0.002) and length of intensive care unit (ICU) stay (6.7 ± 12.2 days vs. 1.5 ± 3.3 days, p = 0.013) compared with the no HO cohort. There was no difference in rates of HO prophylaxis use and subsequent HO among cohorts.

CONCLUSION: This study describes a standardized protocol developed by the senior author that resulted in low rates of HO following acetabular fixation via the Kocher-Langenbeck approach. Patients with HO had a significantly longer time to surgical intervention and length of ICU level of care.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors of a complete description of levels of evidence.

PMID:39718662 | DOI:10.1007/s00590-024-04144-w

Environ Geochem Health. 2024 Dec 24;47(2):31. doi: 10.1007/s10653-024-02327-2.

ABSTRACT

This study investigates the quantities of Rare Earth Elements (REEs) and Potentially Toxic Elements (PTEs) in Dong Nai Province’s surface soils. Atomic Absorption Spectrometry (AAS) and Instrumental Neutron Activation Analysis (INAA) were used to determine element concentrations. To validate the concentration results, established reference materials (NIST 2711 and IAEA Soil-7) were used. Element concentrations followed a certain order, with Mn, Cr, V, and Zn dominating, except for Al, which were used to determine the enrichment factor. Arsenic (As) concentrations ranged from 0.8 to 37.5 mg/kg, exceeding global averages but below Vietnam quality standards. Cadmium (Cd) concentrations ranged from 0.03 to 0.16 mg/kg, below global averages and quality standards. Cobalt (Co) and chromium (Cr) concentrations ranged from 0.5 to 135.1 mg/kg and 18 to 844 mg/kg, respectively, with notable percentages of samples exceeding global averages. Copper (Cu) and lead (Pb) exhibited elevated concentrations, with varying proportions exceeding quality standards. Manganese (Mn) and antimony (Sb) exceeded global averages in a significant percentage of samples. Vanadium (V) concentrations surpassed the crustal average by over half of the sites. Zinc (Zn) concentrations were below reference values. REEs showed significantly higher concentrations than global soil averages, with a substantial proportion of samples exceeding reference values. Geo Accumulation Index (Igeo), Enrichment Factor (EF), and Pollution Load Index (PLI) analyses provided a detailed numerical assessment of contamination and soil quality. Statistical analysis showed correlations and clusters of toxic elements and highlighted the spatial distribution of samples based on elemental compositions.

PMID:39718640 | DOI:10.1007/s10653-024-02327-2

Heart Vessels. 2024 Dec 24. doi: 10.1007/s00380-024-02510-6. Online ahead of print.

ABSTRACT

The optimal procedural protocol for coronary stent deployment remains undetermined. Post-dilation with a high-pressure balloon is often performed to optimize the stent expansion. However, high-pressure dilation also carries the potential risk of coronary artery injury. A previous in vitro study reported that multiple-times balloon inflation at the same pressure resulted in better stent expansion compared to one-time balloon inflation. In our facility, we frequently perform the repeated 3-time-balloon-inflation method, wherein the stent delivery balloon was inflated 3 times at nominal pressure to deploy the stent, to improve stent expansion without high-pressure balloon inflation. Although this method seems effective in avoiding excessive high-pressure dilation, its clinical data are insufficient. In this study, we investigated the clinical outcomes of the repeated 3-time-balloon-inflation method. This retrospective study included 370 patients with 467 stented coronary lesions. These subjects were divided into two groups: one with standard balloon inflation and the other with repeated 3-time balloon inflation, and treatment outcomes were compared. The repeated 3-time-balloon-inflation group had 254 lesions, and the standard-balloon-inflation group had 213 lesions. Stent edge dissection occurred in 6 lesions (2.8%) in the standard-balloon-inflation group, whereas did not occur in the repeated 3-time-balloon-inflation group. A statistically significant difference remained even after propensity score matching (p = 0.040). The final minimum stent area and long-term clinical outcomes were not significantly different between the two groups. The repeated 3-time-balloon-inflation method may reduce stent edge dissection while demonstrating comparable minimal stent area and long-term outcomes to the standard-balloon-inflation method.

PMID:39718636 | DOI:10.1007/s00380-024-02510-6

Abdom Radiol (NY). 2024 Dec 24. doi: 10.1007/s00261-024-04765-z. Online ahead of print.

ABSTRACT

OBJECTIVES: Implementation of diffusion-weighted imaging (DWI) for abdominal imaging in children has challenges due to motion artifacts exacerbated by long acquisition times. We aimed to compare acquisition time and image quality between conventional DWI and multi-band (MB) DWI of the liver in children and young adults.

METHODS: Clinical MRI exams from May 2023 to January 2024 were reviewed, including four DWI sequences: respiratory-triggered (RTr, clinical standard), free-breathing (FB), MB-DWI with shift factor 1 (MBsf1), and MB-DWI with shift factor 2 (MBsf2). Acquisition times were recorded, and signal intensity and apparent signal-to-noise ratio (aSNR) were calculated for the liver and spleen. Six blinded pediatric radiologists independently assessed image quality, artifacts, and lesion visualization on a 5-point Likert scale and identified their preferred sequence. Statistical comparisons were made using Kruskal-Wallis and ANOVA tests.

RESULTS: Median acquisition times were significantly reduced with MB-DWI (43 s for MBsf1/MBsf2) compared to FB (84 s) and RTr (240 s). Image quality and artifact scores were highest for RTr and FB sequences (p < 0.0001). Mean image quality scores were 3.7 (RTr, FB), 3.4 (MBsf1), and 3.5 (MBsf2), while artifact scores followed a similar trend (higher score = fewer artifacts). Lesion visualization scores were comparable across sequences (p = 0.11), and reviewers expressed no preference in 47% of cases. Apparent diffusion coefficient (ADC) values were consistent across all sequences (p > 0.05).

CONCLUSION: MB-DWI significantly reduces acquisition time while maintaining acceptable image quality and lesion visualization, making it a valuable option for pediatric abdominal MRI.

PMID:39718630 | DOI:10.1007/s00261-024-04765-z

Aesthetic Plast Surg. 2024 Dec 24. doi: 10.1007/s00266-024-04638-2. Online ahead of print.

ABSTRACT

BACKGROUND: Oncoplastic surgery for breast cancer patients poses the challenge of achieving optimal aesthetic outcomes without increasing the risk of complications. Omental flap has emerged as n reconstructive option in breast surgery, yet the efficacy and safety of large omental flaps remain uncertain. This study aims to conduct a systematic review and single-arm meta-analysis to comprehensively evaluate the effectiveness, safety, and cosmetic outcomes of large omental flap breast reconstruction, providing updated evidence for clinical practice.

METHODS: We systematically searched Embase, PubMed, Cochrane Library, and CNKI databases until August 2023. Studies were screened using inclusion and exclusion criteria. The quality of each study was evaluated with the Newcastle-Ottawa Scale. Meta-analysis was performed using R version 4.2.0.

RESULTS: A total of 22 studies with 1031 patients were reviewed and analyzed. Meta-analysis results showed that hematoma and seroma rate were 4.1% (95%CI 0.8-8.8, P < 0.01). The pooled cosmetic outcomes demonstrated excellent rate 56.7% (95%CI 46.4-69.3, P < 0.01), good rate 7.9% (95%CI 3.9-11.9, P < 0.01), fair rate 28.7% (95%CI 19.9-37.5, P < 0.01). The pooled blood loss was 110.74 ml (95%CI: 72.33-149.14, P = 0), hospital stays was 7.27 (95%CI 5.65-8.89, P < 0.01), the time of omental flap harvest was 65.63 min (95%CI 59.95-71.32, P < 0.01), the time for surgery was 240.87 min (95%CI 5.65- 8.89, P = 0).

CONCLUSIONS: This meta-analysis indicates that the omental flap in breast reconstruction is safe and effective with good cosmetic outcomes and a low incidence of complications. The study highlights the benefits of comprehensive assessment, warranting further investigation through high-quality studies and long-term follow-up.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:39718627 | DOI:10.1007/s00266-024-04638-2