Tag: pubmed

J Cosmet Dermatol. 2025 Jan;24(1):e16728. doi: 10.1111/jocd.16728.

ABSTRACT

BACKGROUND: Hypertrophic scar (HS) is a fibroproliferative disorder resulting from abnormal healing of skin tissue after injury. Although various therapies are currently employed in clinical to treat HSs, there is no widely accepted standard therapy. Micro-plasma radiofrequency (MPR) and autologous chyle fat grafting are emerging treatments for this condition, and they have demonstrated promising therapeutic outcomes in clinical applications. The aim of this study is to investigate the effectiveness and safety of combining MPR with autologous chyle fat grafting for the treatment of HSs.

METHODS: We performed a retrospective study on patients diagnosed with HS in a single center between January 2020 and December 2023. According to the treatments, patients were divided into three groups, with 6 months follow-up. The single therapy group received MPR alone for two times. The combined therapy Group 1 first received the MPR treatment followed by the combined treatment. The combined therapy Group 2 first received the combined treatment and then received the MPR treatment. The effectiveness of treatment was evaluated using the Vancouver Scar Scale (VSS) and the Patient Scar Assessment Scale (PSAS). The Visual Analog Scale (VAS) was used to assess the patients’ pain on the day of treatment and 1 day after treatment. Adverse events and complications were recorded to assess the safety of treatment.

RESULTS: A total of 73 patients diagnosed with HS were enrolled in this study, including 35 patients in the single therapy group, 18 patients in the combined therapy Group 1, and 20 patients in the combined therapy Group 2. After the treatments were completed, all three groups exhibited significant effectiveness. The two combined therapy groups scored lower after treatments in the VSS, which includes height, vascularity, pliability, and total scores, as well as in the PSAS, which includes color, stiffness, thickness, and total scores, compared to the single therapy group, with a statistically significant difference. Regarding pain response to treatment, there was no statistical difference in VAS among the three groups. No statistical difference in the overall incidence of adverse events was observed among the three groups, and no severe complications were recorded.

CONCLUSIONS: This study revealed the combination of MPR and autologous chyle fat grafting showed superior effectiveness compared to MPR alone in treating HSs, without any observed increase in overall adverse event frequency. For patients diagnosed with HS, this combination therapy stands as a promising and effective clinical intervention.

PMID:39731280 | DOI:10.1111/jocd.16728

Clin Genet. 2024 Dec 27. doi: 10.1111/cge.14687. Online ahead of print.

ABSTRACT

Renal ciliopathies are a genetically and phenotypically heterogeneous group of diseases characterized by cystic and dysplastic kidneys. The aim of this study was to investigate the correlation between genetic changes that cause renal ciliopathies and phenotypic outcomes. The study group consisted of 137 patients diagnosed with renal ciliopathy disease. One hundred nineteen patients had ADPKD phenotype, 7 patients had ARPKD phenotype, 4 patients had nephronophthisis, 1 patient had Senior-Loken syndrome, 4 patients had Bardet-Biedl syndrome, 1 patient had Joubert syndrome and 1 patient had Meckel Gruber syndrome phenotype. Among patients with autosomal dominant polycystic kidney disease, patients with the PKD1 gene mutation had higher creatinine levels (p value: 0.020) and no arachnoid cysts were revealed in the PKD2 group (p value: 0.014). When the domains were compared, the finding of arachnoid cyst in patients with mutations in the transmembrane domain was statistically significant (p value: 0.021). Homozygous likely pathogenic variant in the TCTN1 gene was reported in a fetus who had findings of Meckel-Gruber syndrome; microphthalmia and cardiac hypoplasia were reported as novel findings. As a conclusion, we identified variant spectrum of renal ciliopathies in Turkish cohort and revealed the association between the transmembrane domain and arachnoid cyst.

PMID:39731278 | DOI:10.1111/cge.14687

Dermatol Surg. 2024 Oct 14. doi: 10.1097/DSS.0000000000004452. Online ahead of print.

ABSTRACT

BACKGROUND: The melolabial interpolation flap is an effective surgical technique for reconstructing defects in the nasal ala and tip regions. Traditionally, this technique involves waiting for the standard 3-week period before pedicle division.

OBJECTIVE: To evaluate whether accelerated takedown at 1- or 2-week postflap creation is possible while maintaining the flap’s viability and functionality.

METHODS: Retrospective cohort study at Oregon Health and Science University from 2018 to 2023.

RESULTS: The authors examined 67 patients who underwent reconstruction with a melolabial interpolation flap surgery, of which 50 had their flap takedown at <21 days and 17 had their takedown at 21 or more days. This analysis revealed similar complication rates for both groups. There were no increased rates of infection, necrosis, or hematoma formation in the earlier takedown group. Those undergoing earlier takedown were more likely to have a history of hypertension but less likely to have a history of diabetes, immunosuppression, and smoking, though the differences were not statistically significant.

CONCLUSION: This study provides valuable insights into the safety and feasibility of early melolabial interpolation flap takedown. This approach has the potential to enhance the quality of life for patients undergoing this flap by decreasing the amount of time with a pedicle.

PMID:39729638 | DOI:10.1097/DSS.0000000000004452

J Neurosurg. 2024 Dec 27:1-9. doi: 10.3171/2024.7.JNS241015. Online ahead of print.

ABSTRACT

OBJECTIVE: While the relationship between smoking and subarachnoid hemorrhage is well established, data regarding the probability of detecting unruptured intracranial aneurysms (UIAs) in smokers remain sparse. The aim of this systematic review and meta-analysis is to provide a comprehensive understanding of the relationship between smoking and the likelihood of identifying UIAs in healthy asymptomatic patients who underwent brain imaging for indications unrelated to UIAs.

METHODS: A systematic review was conducted following the PRISMA guidelines. The PubMed and Scopus databases were searched for studies published before March 2024 that reported on the presence of UIAs in healthy asymptomatic patients who had undergone brain imaging for indications unrelated to UIAs. Three independent reviewers assessed the eligibility of all retrieved studies. Risk of bias for the included observational studies was assessed using the methodological index for non-randomized studies. Data on UIA prevalence, smoking status, and patient and aneurysm characteristics were extracted. The association between smoking and the presence of UIA was studied. A prevalence proportional meta-analysis was conducted across the included studies. A meta-analysis was performed with a random-effects model by using summary statistics from the included studies.

RESULTS: Six studies involving 47,788 patients who had undergone brain imaging were identified for quantitative analysis. The pooled UIA prevalence in the sample was 3.07% (95% CI 2.27%-4.16%). Patients who smoked had higher rates of aneurysm detection than the patients who did not smoke (pooled prevalence of 2.96%, 95% CI 2.68%-3.27% vs 2.23%, 95% CI 2.08%-2.39%). Although the relation between the two was not statistically significant (p = 0.06), smoking was associated with higher odds for UIA detection, yielding an OR of 1.34 (95% CI 1.07-1.67) with an I2 value of 53%.

CONCLUSIONS: This study suggests a potentially higher risk of UIAs in patients who smoked than in those who never smoked. However, the results of this meta-analysis revealed that smoking was not statistically associated with higher UIA detection. This result could be explained by the limited number of studies published on this topic. If these findings reach statistical significance in future larger studies, it could justify revising guidelines to include cigarette smokers in intracranial aneurysm screening.

PMID:39729618 | DOI:10.3171/2024.7.JNS241015

J Neurosurg. 2024 Dec 27:1-9. doi: 10.3171/2024.7.JNS24906. Online ahead of print.

ABSTRACT

OBJECTIVE: Pharmacoresistant tremors, often seen in Parkinson disease and essential tremor, significantly impair patient quality of life. Although deep brain stimulation has been effective, its invasive nature limits its applicability. MR-guided focused ultrasound (MRgFUS) thalamotomy offers a noninvasive alternative, but its cognitive impacts are not fully understood. This meta-analysis aimed to evaluate the cognitive and emotional effects of unilateral MRgFUS thalamotomy in patients with pharmacoresistant tremors.

METHODS: Adhering to PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Web of Science, and the Cochrane Library. Studies were included if they involved unilateral MRgFUS thalamotomy and assessed cognitive functions pre- and postprocedure. The primary outcomes were changes in cognitive functions and emotional states postthalamotomy.

RESULTS: Of 90 identified articles, 5 met the inclusion criteria, encompassing 112 patients (74 essential tremor, 38 Parkinson disease). The analysis revealed no significant deterioration in cognitive domains or emotional states postprocedure. Statistical heterogeneity among studies was small for cognitive outcomes but moderate for emotional states.

CONCLUSIONS: Unilateral MRgFUS thalamotomy appears to be a safe procedure with respect to cognitive and emotional outcomes in patients with pharmacoresistant tremors. However, the small number of studies and the short-term nature of assessments necessitate caution. Further research, especially on long-term cognitive effects and in the context of bilateral procedures, is essential for a comprehensive understanding of MRgFUS thalamotomy’s neuropsychological impact. Systematic review registration no.: CRD42023491757 (www.crd.york.ac.uk/prospero).

PMID:39729615 | DOI:10.3171/2024.7.JNS24906

J Neurosurg. 2024 Dec 27:1-9. doi: 10.3171/2024.7.JNS24237. Online ahead of print.

ABSTRACT

OBJECTIVE: Periventricular anastomosis (PA), a recently recognized cause of hemorrhage in moyamoya disease, is reducible after bypass surgery. The timing of the reduction, however, remains poorly understood. The objectives of the present study were to demonstrate radiological reduction of PA occurring within 48 hours after surgery and to identify factors associated with reduction.

METHODS: This retrospective cohort study included patients aged 16 years or older who were diagnosed with moyamoya disease and underwent direct bypass surgery. PAs were assessed using sliding thin-slab maximum intensity projection MR angiography images acquired before surgery and on postoperative day 1. The signal ratio of PA, the ratio of the signal value of the medullary artery to that of the brain parenchyma, was measured at the same point on automatically aligned baseline and postoperative images. The location of bypass was defined as either targeted or nontargeted to the PA.

RESULTS: A total of 68 PAs were analyzed. The signal ratio of PA significantly decreased (mean change [95% CI] -0.16 [-0.21 to -0.11]), while that of cerebellar arteries increased (mean change [95% CI] 0.20 [0.09-0.31]). The interrater reliability measurement of the signal ratio change was excellent (intraclass correlation coefficient 0.94). Multivariate linear regression analysis revealed that targeted bypass (regression coefficient [95% CI] -0.1063 [-0.1558 to -0.0569]) and cross-sectional area of the donor artery (regression coefficient [95% CI] -0.1317 [-0.2101 to -0.0534]) were significant factors contributing to signal reduction of the PA. Analysis of the receiver operating characteristic curve revealed that early signal reduction well predicted late-phase reduction (area under the curve 0.78).

CONCLUSIONS: PA could be reduced within 48 hours after direct bypass surgery, suggesting an early preventive effect against hemorrhage. Early reduction, a potential predictor for late-phase reduction, might be promoted by targeted bypass surgery.

PMID:39729585 | DOI:10.3171/2024.7.JNS24237

Cardiol Rev. 2024 Oct 14. doi: 10.1097/CRD.0000000000000803. Online ahead of print.

ABSTRACT

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by structural and functional abnormalities. Current management strategies, such as medications and septal reduction therapies, have significant limitations and risks. Recently, cardiac myosin inhibitors (CMIs) like mavacamten and aficamten have shown promise as noninvasive treatment options. This meta-analysis aims to evaluate the efficacy and safety of CMIs in HCM patients. PubMed/MEDLINE, Embase, the Cochrane Library, Ovid, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) that compared CMIs to control treatments in HCM patients from inception till June 15, 2024. A random-effects model was used to pool odds ratios (ORs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes along with the corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the χ2 test and Higgins I2 statistic, and sensitivity and subgroup analyses were performed. Six RCTs involving 826 patients were included. CMI therapy significantly reduced resting left ventricular outflow tract (LVOT) gradient (MD, -37.64; 95% CI, -46.71 to -28.56), Valsalva LVOT gradient (MD, -46.04; 95% CI, -57.60 to -34.48), post-exercise LVOT peak gradient (MD, -48.64; 95% CI, -68.20 to -28.88), N-terminal pro-b-type natriuretic peptide levels (MD, -1.05; 95% CI, -1.64 to -0.47), and cardiac troponin I levels (MD, -7.96; 95% CI, -12.84 to -3.07). Improvements were observed in peak oxygen consumption (MD, 1.20; 95% CI, 0.23-2.17) and patient-reported outcomes (Kansas City Cardiomyopathy Questionnaire Clinical Summary Score: MD, 6.44; 95% CI, 3.50-9.37), with more patients achieving New York Heart Association class improvement >1 (OR, 4.05; 95% CI, 2.61-6.30). Treatment-emergent adverse events were higher with CMI therapy (OR, 1.45; 95% CI, 1.02-2.05), but serious adverse events and other safety outcomes were comparable in both groups. CMIs, including mavacamten and aficamten, significantly improve clinical outcomes in HCM patients with a manageable safety profile. These results indicate that CMIs offer a promising noninvasive alternative to septal reduction therapies.

PMID:39729579 | DOI:10.1097/CRD.0000000000000803

Int J Methods Psychiatr Res. 2025 Mar;34(1):e70010. doi: 10.1002/mpr.70010.

ABSTRACT

OBJECTIVES: We implemented the first national patient experience survey, with novel patient-reported experience measures (PREMs), in out- and inpatient mental health and substance use services in Finland.

METHODS: The Outpatient Experience Scale (OPES) and the Inpatient Experience Scale (IPES) were co-designed with experts by experience and professionals. The survey was carried out in 2021 in 435 treatment facilities. We applied bi-factor analysis of ordinal indicators to prespecified and exploratory models.

RESULTS: We received 8794 outpatient and 1112 inpatient responses. Both the OPES and the IPES were essentially unidimensional, with high internal consistency (omega 0.98 in both) and strong factor loadings. The Net Promoter Score item was a fairly poor indicator of overall satisfaction. The most positive experiences were related to respect and acceptance, while statements related to receiving information and inclusion of significant others in the treatment process received more critical feedback. The best experience was in integrated mental health and substance use services. Involuntarily admitted patients had the most negative patient experiences.

CONCLUSIONS: The new PREMs proved to work well in measuring patient experience. Service users generally reported positive experiences. The primary service development need is sharing information with patients.

PMID:39729570 | DOI:10.1002/mpr.70010

MCN Am J Matern Child Nurs. 2024 Nov-Dec 01;49(6):332-340. doi: 10.1097/NMC.0000000000001046. Epub 2024 Oct 15.

ABSTRACT

PURPOSE: To describe the relationship between experiencing traumatic childbirth events and burnout.

STUDY DESIGNS AND METHODS: This descriptive cross-sectional study used an anonymous online survey to assess traumatic childbirth event exposure and the three independent constructs of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Participants were a convenience sample of registered nurses, obstetric residents, family medicine residents, and attending obstetricians across five hospitals from December 2020 through June 2021. The traumatic childbirth event questionnaire measured the frequency of traumatic childbirth event exposure, perception of severity, and perceived influence on the participant’s professional practice and personal life.

RESULTS: Data were analyzed from 150 participants. Registered nurses represented the largest percentage of participants (66%). Components of burnout varied according to race and occupation. Asian/Pacific Islanders had significantly higher mean depersonalization scores at 10.1 (SD = 6.0). Resident physicians had the highest emotional exhaustion scores (M = 34.6, SD = 8.8). Traumatic childbirth events perceived influence on practice correlates with personal accomplishments. Yet, no relationship was observed between traumatic childbirth events, emotional exhaustion, and depersonalization. Linear mixed analysis revealed that hospitals account for 7.5% of the variance in emotional exhaustion scores, 11.1% in depersonalization scores, and 1.3% in personal accomplishments scores.

CLINICAL IMPLICATIONS: Maternity clinicians experience burnout at similar rates to those in other specialties. Although traumatic childbirth events are infrequent and not strongly correlated with emotional exhaustion and depersonalization, hospitals should implement effective strategies to support clinicians after such events. Educational interventions can enhance knowledge and resilience, whereas specialized training effectively alleviates burnout. Development of evidence-based strategies that prioritize the wellbeing of clinicians and patients is crucial.

PMID:39729560 | DOI:10.1097/NMC.0000000000001046

Anal Chem. 2024 Dec 27. doi: 10.1021/acs.analchem.4c03513. Online ahead of print.

ABSTRACT

Mass spectrometry (MS)-based metabolomics often rely on separation techniques when analyzing complex biological specimens to improve method resolution, metabolome coverage, quantitative performance, and/or unknown identification. However, low sample throughput and complicated data preprocessing procedures remain major barriers to affordable metabolomic studies that are scalable to large populations. Herein, we introduce PeakMeister as a new software tool in the R statistical environment to enable standardized processing of serum metabolomic data acquired by multisegment injection-capillary electrophoresis-mass spectrometry (MSI-CE-MS), a high-throughput separation platform (<4 min/sample) which takes advantage of a serial injection format of 13 samples within a single analytical run. We performed a rigorous validation of PeakMeister by analyzing 47 cationic metabolites consistently measured in 5,000 serum and 420 quality control samples from the Brazilian National Survey on Child Nutrition (ENANI-2019) comprising a total of 224,983 metabolite peaks acquired in 40 days across three batches over an eight-month period. A migration time index using a panel of 11 internal standards was introduced to correct for large variations in migration times, which allowed for reliable peak annotation, peak integration, and sample position assignment for serum metabolites having two flanking internal standards or a single comigrating stable-isotope internal standard. PeakMeister accelerated data preprocessing times by 30-fold compared to manual processing of MSI-CE-MS data by an experienced analyst using vendor software, while also achieving excellent peak annotation fidelity (median accuracy >99.9%), acceptable intermediate precision (median CV = 16.0%), consistent metabolite peak integration (mean bias = -2.1%), and good mutual agreement when quantifying 16 plasma metabolites from NIST SRM-1950 (mean bias = -1.3%). Reference ranges are also reported for 40 serum metabolites in a national nutritional survey of Brazilian children under 5 years of age from the ENANI-2019 study. MSI-CE-MS in conjunction with PeakMeister allows for rapid and automated processing of large-scale metabolomic studies that tolerate nonlinear migration time shifts without complicated dynamic time warping or effective mobility scale transformations.

PMID:39729551 | DOI:10.1021/acs.analchem.4c03513