Tag: pubmed

Prostate. 2024 Dec 22. doi: 10.1002/pros.24832. Online ahead of print.

ABSTRACT

INTRODUCTION: The introduction of multiparametric prostate magnetic resonance imaging (mpMRI) has revolutionized prostate cancer (PCa) diagnosis, enhancing the localization of clinically significant prostate cancer (csPCa) and guiding targeted biopsies. However, significant disparities in the execution, interpretation, and reporting of prostate MRI examinations across centers necessitate greater standardization and accuracy. This study compares the diagnostic efficacy of mpMRI from academic and nonacademic centers in detecting csPCa and identifies factors associated with csPCa detection.

MATERIALS AND METHODS: Between July 2018 and October 2023, we prospectively followed 810 men at SS. Annunziata Hospital of Chieti who underwent MRI/US fusion biopsies due to elevated prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE). Patients with mpMRI-documented suspicious lesions classified as PI-RADS ≥ 3 were included. Patients were divided into two groups based on the source of their mpMRI (academic or nonacademic centers). All biopsies were conducted using the MRI/US fusion technique. Clinical, mpMRI, and pathological data were collected and analyzed. Statistical analyses were performed using R software.

RESULTS: The cohort included 354 patients from academic centers and 456 from nonacademic centers. There were no significant differences in patient demographics, such as age and PSA levels, between the groups. Patients at academic centers were more likely to receive a higher number of elevated PI-RADS scores compared to those at nonacademic centers (PI-RADS > 3: 72.6% vs. 62.3%, p = 0.003). Histopathological analysis revealed no significant differences in the ISUP grade distribution between groups. Increased age, PSA levels, and positive DRE were significantly associated with higher odds of detecting csPCa. Median PSA density was significantly higher in patients with csPCa compared to those without csPCa (0.14 vs. 0.11 ng/mL/cm³, p < 0.001). Academic centers exhibited a higher odds ratio for csPCa detection in patients with PI-RADS scores > 3 compared to nonacademic centers.

CONCLUSION: Our study highlights significant variability in PI-RADS score assignments between academic and nonacademic centers, affecting csPCa detection rates. This variability underscores the need for greater standardization in PI-RADS scoring to reduce disparities and improve diagnostic uniformity across centers.

PMID:39709541 | DOI:10.1002/pros.24832

Otolaryngol Head Neck Surg. 2024 Dec 22. doi: 10.1002/ohn.1097. Online ahead of print.

ABSTRACT

OBJECTIVES: We investigate if sublingual space invasion (SLI) determined on magnetic resonance imaging confers differences in clinicopathological manifestations and treatment outcomes of oral tongue squamous cell carcinoma (OTSCC).

STUDY DESIGN: Retrospective cohort study.

SETTING: Tertiary Academic Medical Center.

METHODS: 221 OTSCC patients were included. Cox regression models and Kaplan-Meier methods were used, and nomogram construction was performed, incorporating SLI with other adverse factors, to predict the prognosis.

RESULTS: On multivariable analysis, the following were associated with cervical nodal metastasis: (1) greater MRI T classification of T3/T4 versus T1/T2: adjusted odds ratio (aOR) 2.784, 95% CI = 1.459 to 5.313, P = .001; (2) gender (female vs male): aOR 4.117, 95% CI = 1.602 to 10.576, P = .003; (3) presence of MRI-determined SLI: aOR 2.588, 95% CI = 1.393 to 4.808, P = .002. For survival outcomes, extranodal extension (adjusted hazard ratio [aHR]: 3.380, 95% CI = 2.024-5.644, P < .001), poorly-differentiated type (aHR: 1.720, 95% CI = 1.006-2.943, P = .047), lymphovascular invasion (aHR: 2.100, 95% CI = 1.220-3.614, P = .007), and SLI (aHR: 1.700, 95% CI = 1.086-2.661, P = .020) were statistically significant prognosticators of disease-free survival. In overall survival, when controlled for age, gender, overall TNM stage, Charlson morbidity index, surgical margins, depth of invasion and adjuvant therapy, SLI was a statistically significant prognosticator (aHR: 1.622, 95% CI = 1.012-2.602, P = .044). A proposed novel nomogram for overall survival combining SLI and other risk factors showed a higher concordance index compared to a nomogram with TNM staging alone (0.783 vs 0.629, P < .001).

CONCLUSION: SLI is an independent prognostic factor for treatment outcomes in OTSCC. Incorporating SLI into a novel nomogram demonstrated improved predictive accuracy for post-treatment outcomes.

PMID:39709539 | DOI:10.1002/ohn.1097

BMC Psychol. 2024 Dec 21;12(1):772. doi: 10.1186/s40359-024-02294-4.

ABSTRACT

BACKGROUND: Various factors associated with attitudes toward the utilization of professional psychological help among the school-going population have been explored, but studies from Arabian Gulf countries are lacking. This study aimed to assess attitudes toward seeking professional psychological help, examine how demographic factors and self-esteem are associated with seeking psychological help, and understand the interaction between these variables.

METHODS: A cross-sectional correlational design was used. A random sample of Omani secondary school students (n = 2165) aged 15-18 years completed the demographics sheet, the Scale of Attitudes Toward Seeking Professional Psychological Help (SATSPH), and the Rosenberg self-esteem scale. Hierarchical regression analysis with interaction was performed to test the moderating role of self-esteem in the relationship between selected demographics and attitudes toward seeking professional psychological help (ATSPH).

RESULTS: Most of the adolescents exhibited poor attitudes toward ATSPH. The findings demonstrated a significant moderating effect of self-esteem on the relationship between demographics (sex and age) and ATSPH (ΔR 2 = 0.002, F (7, 2156) = 4.839, p < 0.001). In terms of sex, women may have more positive attitudes toward seeking help than men. However, when self-esteem is considered, the positive effect of being female can reverse at higher levels of self-esteem, suggesting that men with higher self-esteem may have more positive attitudes toward seeking help than women with higher self-esteem. Furthermore, initially, age was not significant. However, when self-esteem was introduced as a moderator, age was a significant predictor. These findings indicate that the effect of age on seeking professional psychological help is influenced by self-esteem.

CONCLUSIONS: This study highlights that attitudes toward seeking professional psychological help among Omani adolescents are generally poor and are influenced by both demographic factors and self-esteem. Although women tend to have more positive attitudes than men do, this can change with varying levels of self-esteem. Similarly, the effect of age on these attitudes is dependent on self-esteem levels. This underscores the complex interplay between demographic factors and self-esteem in shaping attitudes toward psychological help-seeking behaviors. Therefore, more studies of this nature are warranted.

PMID:39709498 | DOI:10.1186/s40359-024-02294-4

Crit Care. 2024 Dec 21;28(1):429. doi: 10.1186/s13054-024-05155-z.

ABSTRACT

BACKGROUND: In septic shock, the classic fluid resuscitation strategy can lead to a potentially harmful positive fluid balance. This multicenter, randomized, single-blind, parallel, controlled pilot study assessed the effectiveness of a restrictive fluid strategy aiming to limit daily volume.

METHODS: Patients 18-85 years’ old admitted to the ICU department of three French hospitals were eligible for inclusion if they had septic shock and were in the first 24 h of vasopressor infusion. Exclusion criteria were acute kidney injury requiring renal replacement therapy, end stage chronic kidney disease, and severe malnutrition. Patients were electronically randomized 1:1 to either an optimized fluid restriction (reducing fluid intake as much as possible in terms of maintenance fluids and fluids for drug dilution during the first 7 days) or standard fluid strategy. The primary outcome was cumulative fluid balance (ml/kg) in the first 5 days. Patients and statisticians were blinded to group arm, but not clinicians.

RESULTS: Between September 2021 and February 2023, 1201 patients were screened and 50 included, with two in the control group withdrawing, thus 48 patients were analyzed (24 in each group). In the first 5 days, the optimized restrictive strategy and control groups received 89.7 (IQR 35; 128.9) and 114.3 (IQR 78.8; 168.5) ml/kg of fluid, respectively (mean difference: 35.9 ml/kg [0.0; 71.8], p = 0.0506). After 5 days, the median cumulative fluid balance was 6.9 (IQR – 13.7; 52.1) and 35.0 (IQR – 7.9; 40.2) ml/kg in the optimized restrictive strategy and control groups, respectively (absolute difference 13.2 [95%CI – 15.2; 41.6], p = 0.42). After 28 days, mortality and the numbers of days alive without life support were similar between groups. The main adverse events were severe hypernatremia in 1 and 2 patients in the fluid restriction strategy and control groups, respectively, and acute kidney injury KDIGO 3 in 4 and 7 patients in the fluid restriction strategy and control groups, respectively.

CONCLUSIONS: In ICU patients with septic shock, an optimized restrictive fluid strategy targeting hidden fluid intakes did not reduce the overall fluid balance at day 5. Trial registration ClinicalTrials.gov identifier NCT04947904, registered on 1 July 2021.

PMID:39709493 | DOI:10.1186/s13054-024-05155-z

AIDS Res Ther. 2024 Dec 21;21(1):97. doi: 10.1186/s12981-024-00676-7.

ABSTRACT

INTRODUCTION: Despite the need for reliable questionnaires to monitor self-management in chronic disease patients, such tools are lacking in developing countries. This study aims to pilot and assess the construct validity of the HIV-SM LMIC questionnaire.

METHOD: The validation of the HIV-SM LMIC questionnaire involved two cross-sectional studies in Ethiopia. The first round, for exploratory factor analysis (EFA), included 261 patients, while the second round, for confirmatory factor analysis (CFA), included 300 patients. Data was collected using the Kobo Collect electronic data entry template.

RESULT: The sample adequacy test showed a good value of 0.82. In the first round, 6 of the 32 items were not loaded, forming three factors in the EFA. Four of these items were dropped, but two (PSMB2 and PSMB12) were retained for their content. In the second round, CFA on the remaining 28 items led to dropping 8 more items due to conceptual overlap, resulting in a 20-item questionnaire. The final items were structured into three dimensions: awareness and well-being (4 items), self-regulation (6 items), and self-management practices (10 items).

CONCLUSION: The study refined the original 32-item HIV-SM LMIC questionnaire to a validated 20-item, three-dimensional tool with an acceptable goodness of fit. The authors recommend further cross-cultural and predictive validation and adaptation for newly diagnosed HIV patients, those with poor treatment outcomes.

PMID:39709486 | DOI:10.1186/s12981-024-00676-7

Syst Rev. 2024 Dec 21;13(1):311. doi: 10.1186/s13643-024-02721-y.

ABSTRACT

INTRODUCTION: Cultural violence includes any offensive behavior regarding ethnicity, race, language, religion, and place of birth devaluing human dignity. The purpose of this study was to investigate workplace cultural violence against nurses by systematic review and meta-analysis.

MATERIALS AND METHODS: The guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The search was independently conducted in ISI, Cochrane Library, Google Scholar, PubMed, and Scopus by two researchers. We used mesh keywords to recruit publications from different regions of the world between 2002 and 2017. Data was analyzed using meta-analysis and STATA software. To determine the heterogeneity, Q and I² indices were used.

RESULTS: A total of 50 articles were found from which 8 were ultimately included in the systematic review process. The overall rate of workplace cultural violence among nurses was 17.25% (95% CI 16.83-17.66, I² = 99.7%, P = 0.0001). Also, the rate of workplace cultural violence against nurses and patients’ relatives and companions was 8.21% (95% CI 7.61-8.81, I² = 99.7%, P = 0.0001). The meta-regression of cultural violence in terms of sample size and year of study rendered a significant decrease in the violence rate by increasing years and sample size (P < 0.001).

CONCLUSION: Although not all cases of cultural violence are reported and recorded, the rate of cultural violence against nurses is decreasing according to the results of our study. Nevertheless, by providing good services and appropriate education to patients, the overall incidence of cultural violence is expected to be further reduced.

PMID:39709471 | DOI:10.1186/s13643-024-02721-y

BMC Complement Med Ther. 2024 Dec 21;24(1):422. doi: 10.1186/s12906-024-04722-9.

ABSTRACT

BACKGROUND: As the primary cause of various preventable illnesses, smoking results in approximately five million premature deaths each year in the US and a multitude of adults living with serious illness. The majority of smokers know the health risks associated with smoking and intend to quit. However, quitting is very difficult partly because of insomnia and stress associated with it. Current tobacco cessation medications are not designed to address these problems, which may have contributed to their limited success in enabling cessation. Novel interventions are thus urgently needed to enhance success rates in tobacco cessation. Based on its historical usage and our preliminary data, kava is such a candidate. Kava, customarily enjoyed by South Pacific Islanders, is known for its relaxing effects, stress-relieving properties, and ability to enhance sleep. In the US, it is marketed and distributed as a dietary supplement due to its recognized calming properties. A pilot trial was performed among active smokers with a one-week ingestion of a kava supplement. The results for the first-time revealed kava’s potential in enabling tobacco cessation with effects on a panel of biological signatures. The primary goal of this trial is to replicate kava’s effects on the biological signatures of tobacco use, stress, and sleep in addition to its compliance and safety among those who smoke.

METHODS: A double-blind randomized placebo controlled two-arm trial will enroll 76 smokers with intention to quit, who will consume AB-free kava at a dietary supplement dose or placebo, 3 times per day for 4 weeks with two follow-ups.

DISCUSSION: The study will (1) monitor the adherence to and safety of AB-free kava consumption among smokers and evaluate changes in smoking habits, and (2) quantify a panel of non-invasive translatable biomarkers to objectively evaluate AB-free kava’s holistic effects on biological signatures associated with tobacco use, stress, and sleep. We hypothesize that AB-free kava is a novel and promising intervention to facilitate tobacco cessation via its holistic effects associated with managing stress and insomnia during abstinence. If the results from this study support our hypothesis, kava could emerge as an affordable and accessible dietary supplement candidate for tobacco cessation.

TRIAL REGISTRATION: registered on 04/14/2023 in ClinicalTrials.gov with the identifier NCT05814055.

PMID:39709468 | DOI:10.1186/s12906-024-04722-9

AIDS Res Ther. 2024 Dec 21;21(1):96. doi: 10.1186/s12981-024-00681-w.

ABSTRACT

BACKGROUND: Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.

METHODS: This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights. Pairwise comparisons were made between DTG-based regimen and each of the other 3-drug regimens, stratified by ART experience.

RESULTS: Among 15,702 PWH (across treatment groups, median age 58-62 years; 94-98% male; 5-11% Hispanic; 44-60% Black; 29-42% White), 5,800 received DTG-based regimens, 2,081 BIC-based regimens, 4,159 EVG-based regimens, 1,607 RAL-based regimens, and 2,055 received DRV-based regimens. Among ART-naïve PWH, there were no statistical differences in the odds of virologic suppression, and 6- and 12-month discontinuations were higher in those on DRV. Among ART-experienced PWH, compared to DTG, those on RAL and DRV were less likely to be suppressed at 6 months (RAL vs DTG: aOR 0.64, 95% CI 0.51-0.81; DRV vs DTG: aOR 0.63, 95% CI 0.51-0.76) and those on EVG and DRV were less likely suppressed at 12 months (EVG vs DTG: aOR 0.82, 95% CI 0.68-0.99; DRV vs DTG: aOR 0.64, 95% CI 0.52-0.80). Those on DRV were more likely to have virologic failure within 12 months (aOR 1.96, 95% CI 1.30-2.97). Six- and 12-month discontinuations were higher in those on RAL and DRV, but less likely for BIC-based regimens.

CONCLUSIONS: DTG-based regimens demonstrated higher levels of effectiveness and durability compared to DRV- or RAL-based regimens and had similar treatment responses as BIC- and EVG-based regimens among ART-experienced older PWH.

PMID:39709467 | DOI:10.1186/s12981-024-00681-w

Cancer Imaging. 2024 Dec 21;24(1):171. doi: 10.1186/s40644-024-00811-7.

ABSTRACT

PURPOSE: Staging of non-small cell lung cancer (NSCLC) is commonly based on [¹⁸F]FDG PET/CT, in particular to exclude distant metastases and guide local therapy approaches like resection and radiotherapy. Although it is hoped that PET/CT will increase the value of primary staging compared to conventional imaging, it is generally limited to the characterization of TNM. The first aim of this study was to evaluate the PET parameter metabolic tumor volume (MTV) above liver background uptake as a prognostic marker in lung cancer. The second aim was to investigate the possibility of incorporating MTV into the TNM classification system for disease prognosis in locally advanced NSCLC treated with chemoradiotherapy.

METHODS: Retrospective evaluation of 235 patients with histologically proven, locally advanced NSCLC from the multi-centre randomized clinical PETPLAN trial and a clinical cohort from a hospital registry. The PET parameters SUVmax, SULpeak, MTV and TLG above liver background uptake were determined. Kaplan-Meier curves and stratified Cox proportional hazard regression models were used to investigate the prognostic value of PET parameters and TNM along with clinical variables. Subgroup analyses were performed to compare hazard ratios according to TNM, MTV, and the two variables combined.

RESULTS: In the multivariable Cox regression analysis, MTV was associated with significantly worse overall survival independent of stage and other prognostic variables. In locally advanced disease stages treated with chemoradiotherapy, higher MTV was significantly associated with worse survival (median 17 vs. 32 months). Using simple cut-off values (45 ml for stage IIIa, 48 ml for stage IIIb, and 105 ml for stage IIIc), MTV was able to further predict differences in survival for stages IIIa-c. The combination of TNM and MTV staging system showed better discrimination for overall survival in locally advanced disease stages, compared to TNM alone.

CONCLUSION: Higher metabolic tumor volume is significantly associated with worse overall survival and combined with TNM staging, it provides more precise information about the disease prognosis in locally advanced NSCLC treated with chemoradiotherapy compared to TNM alone. As a PET parameter with volumetric information, MTV represents a useful addition to TNM.

PMID:39709461 | DOI:10.1186/s40644-024-00811-7

BMC Res Notes. 2024 Dec 21;17(1):376. doi: 10.1186/s13104-024-07046-6.

ABSTRACT

OBJECTIVE: Dengue fever is a rapidly spreading viral disease transmitted by mosquitoes, and it is becoming a global concern. This study aimed to assess the awareness, attitude, and performance of the people in Hormozgan province in carrying out preventive behaviors and dengue fever control methods.

METHOD: This descriptive-analytical study was conducted in 1401 in Bandar Abbas, Iran. A total of 642 men and women participated in the study, and a researcher-made questionnaire was used to collect data on demographic information, awareness, attitude, and performance. The data were analyzed using descriptive statistics.

FINDINGS: The study included 642 citizens of Bandar Abbas, with the majority being male. The average scores for awareness, attitude, and performance were relatively low, indicating insufficient knowledge and weak preventive behaviors regarding dengue fever.

CONCLUSION: The findings suggest a need for educational programs to increase awareness and preventive behaviors among the citizens, especially in essential areas such as protected coverage against mosquito bites and inspection of water accumulation sites in homes. It is also important for health centers and mass media to provide more information and education about dengue fever and its prevention.

PMID:39709455 | DOI:10.1186/s13104-024-07046-6