Tag: pubmed

J Cosmet Dermatol. 2024 Nov 27:e16695. doi: 10.1111/jocd.16695. Online ahead of print.

ABSTRACT

BACKGROUND: One of the worst long-term effects of acne is scarring, which leads to significant physical, psychological, and economic burdens. Limited studies have specifically studied the risk factors for acne scarring. This study aims to explore risk factors associated with facial acne scarring in Thai patients with acne.

METHODS: Exploratory cross-sectional risk factor research was conducted using an online questionnaire on Thai patients aged ≥ 18 years who were diagnosed with acne between September and December 2023. The primary objective was to identify significant determinants of acne scars in patients with acne, including sociodemographic factors, clinical factors of acne, lifestyle factors, dietary habits factors, and treatment factors. Univariable and multivariable logistic regression were used to identify significant risk determinants.

RESULTS: Of 225 patients with 61.33% prevalence of acne scarring, acne scarring was found to be independently associated with the following variables: moderate acne (mOR 3.51, 95% CI 1.31-9.40, p = 0.012) or severe-to-very severe acne (mOR 8.98, 95% CI 2.71-29.73, p < 0.001), sometimes squeezing and picking behaviors (mOR 2.69, 95% CI 2.71-29.73, p = 0.033), and postacne erythema (PAE) (mOR 4.46, 95% CI 1.96-10.14, p < 0.001).

CONCLUSION: The risk factors associated with acne scarring in individuals include the severity of acne, squeezing and picking behaviors, and experiencing PAE. One of this study’s essential findings confirms that PAE is a notable component that could contribute to the development of acne scars. Early treatment of individuals at risk is crucial to reduce scar formation.

PMID:39601200 | DOI:10.1111/jocd.16695

Head Neck. 2024 Nov 27. doi: 10.1002/hed.28003. Online ahead of print.

ABSTRACT

BACKGROUND: There is currently a lack of consensus regarding neuropsychiatric symptoms as an indication for parathyroidectomy in primary hyperparathyroidism (pHPT). The purpose of this study is to perform a systematic review and meta-analyses of pre- and postoperative Beck Depression Inventory-II (BDI-II) scores in patients with pHPT undergoing parathyroidectomy.

METHODS: A search of the literature was performed using Embase, PubMed, Web of Science, PsycINFO, and OvidAll EBM Reviews. Studies were included if they evaluated BDI-II scores in pHPT patients before and after parathyroidectomy.

RESULTS: The literature search returned 1554 studies, of which nine articles met criteria for inclusion. Baseline BDI-II scores were significantly higher in pHPT patients compared to control patients. pHPT patients experienced a statistically significant decrease in BDI-II scores at ≤ 1 and 6 months postoperatively.

CONCLUSIONS: Based on the results of this study, a BDI-II score ≥ 14 could potentially advocate for parathyroidectomy in patients with pHPT.

PMID:39601197 | DOI:10.1002/hed.28003

J Med Virol. 2024 Nov;96(11):e70089. doi: 10.1002/jmv.70089.

ABSTRACT

The risks of uveitis development among monkeypox (MPOX) patients are unclear. To determine the uveitis risks after (MPOX) diagnosis. Population-based, retrospective cohort study used the TriNetX database and recruited those with and without MPOX diagnosis from January 1, 2016, to December 31, 2023. The non-MPOX cohort consisted of randomly selected control patients matched by covariates, including age, gender, ethnicity, race, relevant comorbidities, previous medications, and the inflammatory marker C-reactive protein. Statistical analysis on uveitis risk included hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated over 8 years (2016-2023). A separate analysis of the risk of uveitis among MPOX patients aged 20 years and older was also conducted. (MPOX) diagnosis, identified using electronic diagnostic codes. Cumulative incidence of new-onset uveitis. A total of 5449 MPOX patients of all ages (25.45% female; mean age at index 35.17 ± 15.70 years) and 5449 propensity-matched non-MPOX comparators (23.97% female; mean age at index 35.30 ± 15.91 years) were recruited from the TriNetX database. For both the overall MPOX patient population and the adult MPOX patients, the risk of uveitis was significantly higher compared to the non-MPOX cohort. This increased risk mainly happened in patients with anterior uveitis. Specifically, the hazard ratio for uveitis in all MPOX patients was 2.59 (95% CI: 1.40-4.79). Among MPOX patients aged 20 years or older, the hazard ratio for uveitis was 2.14 (95% CI: 1.17-3.94). There is a notable association between new-onset uveitis and patients with MPOX. Our real-world findings underscore the importance of being aware of the potential risk of anterior uveitis in this patient population.

PMID:39601175 | DOI:10.1002/jmv.70089

J Med Virol. 2024 Nov;96(11):e70093. doi: 10.1002/jmv.70093.

ABSTRACT

Hematopoietic stem cell transplantation is a curative therapy for pediatric patients with malignancies and blood or immune system disorders. However, recipients are at risk of opportunistic infections, including cytomegalovirus infection, due to immunosuppression from conditioning regimens. This retrospective study analyzed 439 pediatric hematopoietic stem cell transplantation patients to identify risk factors for cytomegalovirus infection and assess the impact of conditioning regimens. Significant factors included graft source, graft versus host disease, and pre-transplant clinically significant cytomegalovirus infection. Myeloablative conditioning regimens and the use of anti-thymocyte globulin increased the risk of clinically significant cytomegalovirus infection. Additionally, the risk of cytomegalovirus infection in patients was found to be statistically significant in the myeloablative subgroup analyses who received anti-thymocyte globulin alone and those who received both anti-thymocyte globulin and total body irradiation. In our study, total body irradiation did not significantly affect the risk of clinically significant cytomegalovirus infection. This study covers a 10-year period and a large pediatric patient population from a single center. Our findings highlight the importance of understanding risk factors for clinically significant cytomegalovirus infection to guide preventive strategies in pediatric HSCT recipients.

PMID:39601160 | DOI:10.1002/jmv.70093

Stroke. 2024 Nov 27. doi: 10.1161/STROKEAHA.124.045607. Online ahead of print.

ABSTRACT

BACKGROUND: Lack of a dedicated thrombectomy device for cerebral venous thrombosis hinders the recanalization ability of endovascular treatment (EVT). Novel NiTi-braided stent retriever (Venous-TD) is a dedicated venous sinus thrombectomy device. This study aims to demonstrate the safety and efficacy of Venous-TD.

METHODS: In this pilot, prospective, randomized, single-blind, parallel-group control, single-center clinical study, patients with cerebral venous thrombosis from Beijing Xuanwu Hospital were included. Randomization was performed to EVT with either the Venous-TD or Angioguard with Sterling balloon (control group). The primary efficacy outcome was the proportion of immediate complete recanalization during EVT. Secondary outcomes included the proportion of functional independence and moderate to severe residential headache at 180 days after EVT. Safety outcomes included peri-procedural complications, all-cause mortality, and symptomatic intracranial hemorrhage after EVT.

RESULTS: A total of 61 patients were enrolled and randomized. Thirty-one patients were randomized to the Venous-TD group, and 30 were randomized to the control group. The median (interquartile range) age was 28 (21-45) in the Venous-TD group and 34 (24-43) in the control group. The proportion of patients with a National Institutes of Health Stroke Scale score >8 on admission was 8 (25.8%) in the Venous-TD group and 11 (36.7%) in the control group. During EVT, Venous-TD significantly improved the proportion of complete recanalization compared with Angioguard (23 [76.7%] versus 6 [20.0%]; relative risk, 3.833 [95% CI, 1.825-8.054]). The proportions of long-term functional independence at 180 days in the Venous-TD group and the control group were not significantly different. The proportion of patients with severe residual headache at 180 days in the Venous-TD group was significantly lower than that in the control group (3 [9.7%] versus 10 [35.7%]; relative risk, 0.271 [95% CI, 0.083-0.886]). Safety outcomes showed no statistically significant difference between the 2 groups.

CONCLUSIONS: This trial indicated that Venous-TD did not increase complications in EVT of cerebral venous thrombosis and can significantly increase the proportion of complete recanalization. A multicenter phase III randomized control trial assessing efficacy and safety of Venous-TD is warranted.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05291585.

PMID:39601121 | DOI:10.1161/STROKEAHA.124.045607

Headache. 2024 Nov 27. doi: 10.1111/head.14874. Online ahead of print.

ABSTRACT

BACKGROUND: The Migraine-Specific Quality-of-Life Questionnaire version 2.1 (MSQ 2.1) is one of the most frequently used tools in assessing the impact of migraine in clinical practice and in migraine research. This work aimed to examine the reliability and validity of the Arabic version of the MSQ 2.1 in Arabic-speaking patients with migraine and to assess its ability to detect subtle changes in quality of life after receiving prophylactic migraine medications.

METHODS: This multicenter prospective observational study was conducted with 140 patients experiencing migraine and indicated for prophylactic medications. Headache assessment was done at baseline and 3 months after receiving prophylactic medications using the Arabic version of MSQ 2.1, Headache Impact Test (HIT-6), and visual analog scale (VAS). The MSQ 2.1 was repeated 1 week after the first visit to a group of patients (n = 70) to assess test-retest reliability.

RESULTS: Cronbach’s alpha for the MSQ 2.1 was 0.973, indicating excellent internal consistency. The intraclass correlation coefficient (average measure) was 0.99, indicating excellent test-retest reliability. There were statistically significant correlations between the MSQ 2.1 total score and monthly migraine days, VAS, and HIT-6 scores before and 3 months after prophylactic medications. The receiver operating characteristic curve revealed that an increase of 8.5 in the total score of the MSQ 2.1 represents the minimally important change that means significant improvement (area under the curve = 0.785, sensitivity = 0.861, specificity = 0.656, p < 0.001).

CONCLUSION: The Arabic version of the MSQ 2.1 is a valid, reliable, and sensitive tool that can precisely assess the impact of migraine on quality of life.

PMID:39601107 | DOI:10.1111/head.14874

Laryngoscope. 2024 Nov 27. doi: 10.1002/lary.31933. Online ahead of print.

ABSTRACT

OBJECTIVE: Patients with obstructive sleep apnea (OSA) are at an increased risk for perioperative cardiopulmonary complications. Our objective was to assess the postoperative effects of hypoglossal nerve stimulation implantation (HGNS) and expansion pharyngoplasty (EP) on longitudinal sleep apnea measures as a surrogate for respiratory complications.

STUDY DESIGN: Prospective longitudinal cohort study of patients with OSA undergoing HGNS or EP.

METHODS: Sleep studies were performed with the NightOwl Mini peripheral arterial tonometry (PAT) device. Changes in apnea-hypopnea index (AHI) and oximetry time below 90% (T90) were assessed between two baseline PAT studies prior to surgery and nightly PAT studies for the first postoperative nights (PON) 1-7, 10, and 14.

RESULTS: Thirty patients were enrolled (19 HGNS, 11 EP). The mean age was 52.6 years, 76.7% were male, and the mean clinical baseline AHI was 29.8/h. There were no significant changes in the AHI or T90 following HGNS implantation. Following EP, there was a statistically significant mean increase in AHI of +19.2/h on PON1, +24.9/h on PON2, and + 20/h on PON3 compared to baseline. T90 was also elevated after EP on PON1, 4, and 5. The mean increase in T90 was +7.4% (95% CI 2.9, 11.9) on PON1 compared to baseline.

CONCLUSIONS: In the immediate postoperative period, there were no significant changes in AHI or hypoxemia after HGNS, suggesting that there is no need for routine overnight observation after HGNS. There were significant increases in AHI and hypoxemia after EP suggesting that postoperative disposition should be considered on a case-by-case basis.

LEVEL OF EVIDENCE: III Laryngoscope, 2024.

PMID:39601102 | DOI:10.1002/lary.31933

Headache. 2024 Nov 27. doi: 10.1111/head.14860. Online ahead of print.

ABSTRACT

BACKGROUND: The Trial of External trigeminal nerve stimulation (eTNS) for the Acute treatment of Migraine (TEAM) study demonstrated that eTNS use during active migraine resulted in significantly higher rates of resolution of migraine-associated most bothersome symptom (MBS) compared to sham. However, no previous studies have examined the association between pretreatment MBS subtype and efficacy of eTNS treatment for active migraine.

OBJECTIVE: We conducted a post hoc analysis examining efficacy of eTNS for different pretreatment MBS subtypes using TEAM study data.

METHODS: Pretreatment MBS subtypes included photophobia (n = 345), nausea (n = 109), phonophobia (n = 73), and vomiting (n = 11). We examined MBS sub-group × treatment group (verum n = 259; sham n = 279) interaction for each post-treatment outcome to explore differential effects conditional on the total sample. We further explored direct, between treatment group comparisons for each MBS subtype, as well as compared treatment outcomes among all MBS subtypes within the sham, verum, and total sample. Finally, clinical heterogeneity of treatment effect (HTE) was assessed using a 1% absolute treatment effect difference as the clinically important threshold.

RESULTS: Significant sub-group × treatment interactions were found for resolution of MBS at 2 h (p = 0.008), pain relief at 2 h (p = 0.001), rescue medication between 2 and 24 h (p = 0.012), sustained pain freedom at 24 h (p = 0.033), and sustained pain relief at 24 h (p = 0.003). Significant sub-group × treatment interactions were not found for pain freedom at 2 h (p = 0.054) or absence of all symptoms at 2 h (p = 0.265). Between treatment group comparisons indicated that pain freedom after 2 h of eTNS was not significantly different between the verum and sham groups for any pretreatment MBS. The verum group had a significantly greater proportion of participants who had resolution of nausea MBS after 2 h of treatment compared to sham (37/55 [67.3%] vs. 25/54 [46.3%], respectively; p = 0.028) and resolution of photophobia MBS compared to sham (85/162 [52.5] vs. 71/183 [38.8%], respectively; p = 0.011). There were no significant differences between treatment groups for phonophobia or vomiting. Pain freedom after 2 h of eTNS was not significantly different among pretreatment MBS groups. Within the sham group and total sample, a greater proportion of participants who had vomiting MBS had resolution of their MBS compared to any other pretreatment MBS (p < 0.05 after Bonferroni adjustment). A greater proportion of participants with nausea MBS used rescue medications between 2 and 24 h after eTNS compared to participants with photophobia or phonophobia MBS within the verum and total sample (p < 0.05 after Bonferroni adjustment). No statistical differences were found among MBS groups for any other treatment outcomes. Clinically important HTE was present in vomiting MBS for resolution of MBS and present in nausea MBS for pain freedom and pain relief after 2 h, need for rescue medication, and sustained pain freedom at 24 h post-treatment. There was no clinically relevant HTE in the nausea MBS group for resolution of MBS at 2 h, absence of all migraine-associated symptoms and sustained pain relief at 24 h, or for any endpoint for other MBS subtypes.

CONCLUSION: Our results suggest the presence of both statistically significant HTE as well as clinically meaningful HTE. Statistical differences were primarily found for photophobia MBS, while clinically meaningful HTE was primarily found for nausea MBS. These findings may be clinically relevant for patients and clinicians when developing a treatment plan for acute treatment of migraine. Further studies are needed to elucidate the underlying pathophysiological differences between MBS subtypes and treatment optimization, particularly for patients with nausea MBS subtypes.

PMID:39601100 | DOI:10.1111/head.14860

J Magn Reson Imaging. 2024 Nov 27. doi: 10.1002/jmri.29668. Online ahead of print.

ABSTRACT

BACKGROUND: The long-term prevalence of clinically significant prostate cancer (csPCa) in patients with initial negative prostate biopsy is unknown.

PURPOSE: To investigate the rate of csPCa of men with initial negative biopsy.

STUDY TYPE: Retrospective analysis of prospectively collected data.

POPULATION: A total of 197 men (mean age 63 years [SD ±6.98, range 29-79]) without csPCa on initial biopsy and available baseline biparametric prostate MRI (bpMRI).

FIELD STRENGTH/SEQUENCE: 3.0 T, turbo spin-echo T2-weighted (axial and sagittal) and three sets of diffusion-weighted imaging using single-shot spin-echo planar imaging (5 b-values 0-500 seconds/mm²; 2 b-values 0 and 1500 seconds/mm², and 2 b-values 0 and 2000 seconds/mm²).

ASSESSMENT: BpMRI was read using Prostate Imaging Reporting Data System (PI-RADS) v2.1. Systematic or targeted biopsy results served as reference standard.

STATISTICAL TESTS: Continuous variables were compared using Kruskal-Wallis rank sum test. Categorical variables were compared using either Fisher’s exact test or Pearson’s chi-square test. Uni- and multivariate regression odds ratios (95% confidence interval) were used to study factors affecting csPCa being diagnosed during follow-up. Time to diagnosis of csPCa is calculated using the Kaplan-Meier method.

RESULTS: Of 197 men, 74 (38%), 57 (29%), and 66 (34%) presented with PI-RADS 1-2, 3, and 4-5 findings in the baseline bpMRI. During the median follow-up of 52 months, 8.1%, 5.3%, and 18.2% of these men were diagnosed with csPCa, respectively. Baseline PI-RADS finding was the only factor that associated with csPCa found during the follow-up.

DATA CONCLUSION: Baseline bpMRI with PI-RADS scores 1-3 and initial biopsies negative of csPCa had low rate of csPCa during follow-up, which supports more conservative follow-up for them but further research with longer follow-up is warranted.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

PMID:39601084 | DOI:10.1002/jmri.29668

Belitung Nurs J. 2024 Nov 24;10(6):654-661. doi: 10.33546/bnj.3565. eCollection 2024.

ABSTRACT

BACKGROUND: In China, the incidence of hypertension rises significantly with age, resulting in a markedly reduced quality of life (QoL) among older patients compared to the general population. Therefore, it is essential for healthcare providers, particularly nurses, to identify the predictive factors that influence QoL in this demographic.

OBJECTIVE: This study aimed to describe the QoL levels and investigate the predictive power of perceived health status, self-care behavior, and social support on QoL among older patients with hypertension in Wenzhou, China.

METHODS: A cross-sectional study was conducted with 131 patients with hypertension aged 60 and above, visiting the Cardiovascular Outpatient Department of The Second Affiliated Hospital of Wenzhou Medical University. Data were collected using validated instruments between November and December 2022 and analyzed using descriptive statistics and stepwise multiple regression.

RESULTS: The overall QoL was moderate (Mean = 75.52, SD = 5.86). Self-care behavior (β = 0.421, p <0.001), social support (β = 0.416, p <0.001), and perceived health status (β = -0.170, p <0.001) were significant predictors of QoL, collectively explaining 82.7% of the variance.

CONCLUSIONS: The findings highlight the importance of self-care behavior, social support, and perceived health status as critical factors influencing QoL among older patients with hypertension. Nurses and other healthcare providers should focus on enhancing these areas through targeted education and support initiatives to improve the overall well-being of this vulnerable population.

PMID:39601033 | PMC:PMC11586613 | DOI:10.33546/bnj.3565